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BMA says government plan to amend Car-Hill

GPC chair claims there is not enough evidence for the changes

Mark Gould

Tuesday, 30 October 2012

BMA GP Committee chair Dr Laurence Buckman says the Government is seeking to press ahead with altering the Carr-Hill funding formula to give greater weight to deprivation factors.

In a letter to BMA members published in Pulse magazine today he claimed there was not enough data to inform such a fundamental change to the distribution of practice funding.

The GPC had initially agreed ‘in principle’ earlier this year to look at formula changes as part of next year’s contract, but announced in August that it had decided against any change at this time.

A Department of Health spokesperson would not comment on the specifics of the letter, saying that the department was still engaged in talks with the BMA over funding.

However amendments to the Carr-Hill formula have been discussed since 2009, when a think-tank report called for patient premiums to be paid for GPs in a bid to encourage them to work in areas with high deprivation, and for practices to be paid according to the age and postcode of their patients.

As part of the coalition agreement, the Government pledged to look at increasing funding for practices in the most deprived areas via a so-called ‘patient premium’.

Dr Buckman said BMA analysts had found a lack of evidence on which to base such allocation decisions and not enough evidence to prove a link between deprived populations and practice workload.

He wrote: ‘A part of these changes [to the 2013/14 GP contract], the Government intends to make adjustments to the Carr-Hill formula to give greater weight to deprivation factors.

‘Previously, when our analysts explored this with the Department of Health, they encountered a paucity of relevant research and data to inform any such change.

‘The GPC believes that there are better ways to improve the health of patients in deprived areas than changing the funding formula, especially as there is little published evidence to suggest a link between population deprivation and practice workload.

‘We sincerely hope that the Government will think very carefully about what it is doing to avoid un-evidenced, unnecessary and destabilising changes to practice funding.’

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