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GMS pay model ‘will not be fully revised until 2015’

28 November 2011

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Whole-scale revision of the Carr-Hill formula will not happen until after the next general election, it is predicted.

The rumour mill has gone into overdrive recently with claims being made that the Carr-Hill formula will be scrapped in favour of a payment-per-patient scheme.

The Carr-Hill formula allocates funding to practices on the basis of the practice population, weighted for factors such as age and sex.

The formula, which replaced the Jarman Index in 2004, only applies to those practices operating under a GMS contract.

Dr David Jenner, GMS and PMS Practice-Based Commissioning Lead at the NHS Alliance, said he is in “no doubt” of the push to go down the “simpler funding route” that will carry weighting for each patient according to their age, health problems, geographical area, specific deprivation and ethnicity.

He said up until now there hasn’t been a tool available that has been “reliable enough” to go down to population numbers to enable a payment-per-patient funding model.

He has been told “this is changing”.

Despite this, Dr Jenner claimed changes to GP funding are not “imminent”.

“There will be more of a tweaking of the Carr-Hill formula before the general election thanks to Lib Dem pressure,” Dr Jenner told MiP.

“We will not see a whole-scale revision of GP funding until after the election as this is likely to be controversial and the Government is already battling hard enough against GPs as it is.” 

He also said any major changes to the Carr-Hill formula are also likely to happen after the amalgamation of General Medical Services (GMS) and Personal Medical Services (PMS) contracts – implying this too will happen after the next general election.

In a statement to MiP, Dr Laurence Buckman, Chair of the British Medical Association’s (BMA) GP Committee, said the government has approached the organisation to review GP funding but claimed this does not mean the Carr-Hill formula will be removed.

“There are no current discussions taking place between the BMA and the Department of Health about alterations to the Carr-Hill formula,” said Dr Buckman.

“We have agreed in principle to begin discussions after 2013 about matters related to deprivation indicators after an approach by the government, but this dialogue has not started in any form and does not mean that the Carr-Hill formula will be removed. 

“The last major review of the formula in 2007 found that it was broadly doing its job.”