NHS England Predicts £50 Million Primary Care Underspend

New figures released by NHS England concede that the healthcare body will underspend by nearly £50 million on primary care.

This revelation formed part of the final financial records released before the end of the fiscal year.

£8.65 billion is set aside for general practice and other primary care services in the current NHS budget, but only £8.6 billion will be spent this year.

A finance report from NHS England outlines the current situation.

“Commissioning expenditure for the year includes a reserve for non-recurrent investment expenditure of 1% of allocations (ca. £800m), which is currently uncommitted but will be used as necessary to offset any overspends across the health system to ensure the delivery of overall financial balance”.

Thus, there will undoubtedly be question marks about the way that the extra £220 million of funding for general practice is being distributed.

Nonetheless, the year-to-date budget for NHS England is £61 million overspent, with a record high number of clinical commissioning groups expecting to end the financial year in deficit.

GP leaders expressed their understanding of the financial challenges facing the NHS system, but called on the NHS in England to ensure that general practice is appropriately remunerated next year.

Commenting on the issue, GPC commissioning lead and chief executive of Wessex LMCs Dr Nigel Watson suggested that the onus is on the government and authorities to handle the situation appropriately.

“This “primary care” budget includes prescribing, IT, premises, and other things, so quite often there is slippage and they don’t over commit money. When we’ve looked at CCG board report budgets, primary care is almost always zero or underspent, partly because of the budget being ring-fenced. One would hope that, with past lack of investment in general practice and current challenges, that money would be recycled to investing into primary care to develop what we need to do instead of just being reported as underspend.”

There is no doubt that the Royal College of General Practitioners will be following this news extremely closely, particularly as the authoritative organisation has previously warned that there are major problems with financial stability in general practice.

The RCGP had stated that there is a danger of CCGs being allowed to use hundreds of millions earmarked for practices to plug hospital deficits, and that this would have a detrimental impact on general practice.

Twelve months ago, only 30 CCGs predicted a deficit, but “there are 98 CCGs reporting year to date overspends, of which 60 are greater than 1%. There are 71 CCGs forecasting a year-end overspend, of which 27 are forecasting unplanned cumulative deficit positions,” according to the report.

Responding to the publication of the report, a spokesperson on the behalf of NHS in England outlined the position of the healthcare body.

“The board paper refers to wider primary care spend, which includes dentistry, opticians and other non-medical services, so is much broader than general practice services which are not expected to underspend. What’s more, the GP contract is fully funded, and is demand-led so we would not anticipate any underspend on the GP contract this year.”


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