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Practices are not receiving funding based on local needs

15 February 2018

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The allocation of primary care funding in England does not take into consideration local needs, a study published today has found.
The research, which has been published on the BMC Medicine, has found that practices in London receive more funding despite serving a population with the lowest health needs in the country.
Instead, the North East and North West of England which have the highest and second highest health needs in England receive lower funding per patient than they should.
The study also showed that practices in rural areas receive an extra £36 per person each year, compared to urban areas when health care needs, deprivation and age are taken into consideration.
The report said: ‘High morbidity and, especially, rural location were very strongly associated with higher practice funding, while associations were more modest for high deprivation and older age.’
This comes despite practices in rural areas usually look after older but relatively healthier, more affluent and smaller population when compared to urban practices, the researchers have found.
A new chronic morbidity index (CMI)
The team of researchers from the University of Manchester, York, Keele, Michigan and Dundee examined data from 7,779 GP, covering over 99% of the population registered with primary care.
To determine the unfair allocation of funding, they created a new chronic morbidity index (CMI), which they calculated by summing 19 chronic condition registers in the Government’s 2014-15 Quality and Outcomes Framework, divided by the total practice population.
Their formula allowed them to conclude that ‘the current allocation of resources to primary care does not account for all important health needs’.
Change is needed for a fairer system
Professor of Health Policy at The University of York Tim Doran said: ‘The Carr-Hill formula, which is used to allocate NHS funding, is based on a range of data, some of which are inaccurate, unrepresentative or out of date. As a result, the formula does not accurately reflect the health care needs of local populations.’
As Management in Practice previously reported, the government previously revised the Carr-Hill global sum formula to take into accounts levels of deprivation.
Lead author of the study Professor Evangelos Kontopantelis said: ‘If as a society we want a healthcare system which is fair, then we must fund it according to need, and ideally account for the impact of deprivation.’

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