Negotiations have begun on new national GP funding formula

BMJ 2016; 354 doi: (Published 17 August 2016) Cite this as: BMJ 2016;354:i4551
  1. Abi Rimmer
  1. BMJ Careers
  1. arimmer{at}

NHS England and the BMA have entered negotiations to agree a new funding formula for GP practices.

The new formula will replace the current global sum formula, also known as the Carr-Hill formula, which doctors have warned does not fund practices appropriately.1 NHS England said that it would not seek to implement any changes to the funding formula before 1 April 2018.

The ambition of the change, it said, was to distribute funding more fairly. “We want to achieve this in a way that does not threaten stability and in a way that does not cause financial uncertainty for practices,” NHS England said.

The change is being made, NHS England said, to deliver on the commitments made in its General Practice Forward View, published in April this year.2

It said that many people believed that the Carr-Hill formula was “out of date and needed to be revised to reflect changes in the population and the impact of this on comparative workload.”

The BMA has previously argued that the funding formula must fairly reflect the workload of practices, including activity that is common to all practices that is not related to the demographics of the patient population. “This is not a simple task and careful modelling must take place to ensure the effects of altering the formula are fully understood,” the BMA said.3

NHS England said that it was also in the process of developing national guidance for commissioners, focusing on three particular population types. These were university practices, unavoidably small and isolated practices, and practices with a significant proportion of the patient list who cannot communicate in English.

NHS England said the guidance would “illustrate for commissioners the workload challenges that practices face and guide commissioners to relevant data sources or intelligence to assist them in making decisions regarding sustainable support.”


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