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Announced funding is not new money, insists Nuffield Trust

PM claims additional £3.5bn a year shows commitment to primary and community healthcare

Louise Prime

Thursday, 22 November 2018

"New" funding for primary and community healthcare by 2023/4 under the NHS Long-Term Plan will mean that more NHS patients will be cared for at home and in their community to avoid them going into or staying in hospital unnecessarily, Theresa May announced late yesterday. The Royal College of GPs (RCGP) said it welcomed "any investment in primary care", but independent health think tank the Nuffield Trust argued that the additional money simply amounts to annual increases that are broadly in line with the 3.4% overall that the NHS in England is getting over the next five years.

The prime minister pledged to cut needless hospital admissions and help in-patients to return home sooner, through community-based rapid response teams and dedicated support for care home residents. She said this "major new investment in primary and community healthcare" of £3.5bn a year in real terms by 2023/4, building on the existing NHS budget for these services, was an "historic commitment to ensure a growing share of overall NHS spending for primary medical and community healthcare".

She pointed out that more than a third of admissions are thought to be avoidable, and up to a third of people in hospital stay longer than they need to, often because they can’t get treatment close to home. She said 24/7 rapid response teams comprising doctors, nurses and physiotherapists will provide urgent care and support in the community as an alternative to hospital, including emergency treatment as well as support to help patients recover closer to home to "help people stay healthy and independent for longer".

Theresa May said: “In reality many patients would be much better off being cared for in the community… That’s why I’m announcing a major boost in funding for community healthcare, which will give more patients a genuine and high-quality alternative to hospital.”

Health secretary Matt Hancock added: “GPs are the bedrock of the NHS. To make the NHS sustainable for the long-term we need more prevention as well as cure. So, we will back our GPs, primary and community healthcare to help keep people healthy and out of hospital in the first place.”

The RCGP said it welcomed any investment in primary care, and specifically in general practice. College chair Professor Helen Stokes-Lampard commented after the announcement: “It is an important step forward to meeting our calls for our service to receive 11% of the overall NHS England budget, and achieving some of the College's aspirations for the future of general practice, particularly around providing a wider range of services in the community – but it certainly doesn’t go all the way.”

The Nuffield Trust responded that, according to its calculations (based on a baseline spend on primary care, community and GP services of £21.7bn in 2017-18), the announcement did not represent real, new money for primary care – and even if it did, the NHS might not have the staff to implement the plans.

Its senior policy analyst Sally Gainsbury said this morning: “This additional money amounts to annual increases that are broadly in line with the 3.4% overall that the NHS in England is getting over the next five years.

“That means that, far from representing a big shift in funding towards out-of-hospital services, this money will simply allow GPs and community services to keep up with demand over the next five years. That’s important, but it means the new money announced today is not going to lead to a significant change in the way that people experience healthcare.

“In many ways this is unsurprising. There are many existing calls on the new money pledged by the prime minister, like getting waiting times back on track and upgrading mental health services. We’ve calculated this will leave relatively little for any significant reform over the next couple of years.

“What’s more, even if this money did represent a major boost to primary and community services, there are serious questions about whether the NHS has the right staff in the right places to carry this out.”

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