Investment in general practice rises slightly after years of cuts

BMJ 2016; 354 doi: (Published 22 September 2016) Cite this as: BMJ 2016;354:i5179
  1. Adrian O’Dowd
  1. London

The amount of money invested into general practice in the United Kingdom has fallen by around 2% over the past decade but has slightly improved in the past few years, new figures have shown.

A report published on 21 September by NHS Digital showed a slight upturn after years of falling investment.1

The government allocated £11.03bn (€12.84bn; $14.32) to general practice in the UK in 2015-16, which represented a 4.36% increase on the previous year (£10.57bn). Excluding drugs reimbursement, UK funding rose by 4.67% (£10.31bn in 2015-16 compared with £9.85bn in 2014-15).

However, the BMA has called on the government to end what it described as a “decade of underinvestment” in general practice. The BMA has calculated that the proportion of funding that GP services received had fallen as a proportion of the NHS budget from 10% in 2004-05 to 8.1% in 2015-16.

England has done better than the rest of the UK, as the figures showed that total funding for general practice in England (including drugs reimbursement) rose by 4.72%, from £9.03bn in 2014-15 to £9.45bn last year. Meanwhile, Northern Ireland saw total funding rise by 4.52% to £267m, Wales’s funding rose 2.15% to £488m, and Scotland’s rose by just 1.53% to £822m.

Another report published by NHS Digital at the same time contained figures for England for 2015-16 that included the global sum, the minimum practice income guarantee, balance of personal medical services expenditure, Quality Outcomes Framework, and enhanced services.2

It found only a small rise in investment over the past year, showing that the sum of NHS payments was £8.18bn across 7841 general practice service providers, compared with £7.99bn to 7959 providers in 2014-15. Broken down, this meant that the average NHS payment to a provider for each registered patient was £142.62 in 2015-16 and £141.09 in 2014-15.

Chaand Nagpaul, the BMA’s GP committee chair, said, “As the detail behind these figures confirm, general practice has suffered from a decade of underinvestment with the proportion of funding GP services receive dropping as a proportion of the NHS budget from 10% in 2004-05 to 8.1% today.

“This is despite an unprecedented surge in pressure on general practices, with rocketing demand, especially from an older population with complex needs, widespread staff shortages, and more care being moved from secondary care into the community.

“There are signs that the proportion of funding is beginning, on a small scale, to increase, however this does not match the relentless expansion in workload and activity in GP surgeries which has left many without the necessary resources to sustain an effective service to patients. Much of the funding increases recorded in this report derive from one-off payments from the PM [Prime Minister] Challenge Fund and other pilots.

“What is really needed is for the government to implement immediately its promised injection of extra resources and a proper recruitment drive in general practice so that we can ensure GP services are able to deliver the care the public deserves.”


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