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NHS England statement re Carr Hill formula

Wednesday 17 August 2016

NHS England and the BMA have released a joint statement on the Carr Hill formula this week.  I reproduce it below for you.


Yet again the review of the Carr Hill formula is deferred for another year.  We are disappointed.  While we welcome the intentions of NHS England, we do wonder if they fully appreciate the magnitude of the crisis in general practice- as seniority, MPIG and PMS transition payments dwindle and are channelled into the core payments practices receive based on this deeply flawed formula.


Joint statement from NHS England and BMA

NHS England and the BMA want to ensure that we deliver on the commitments made in the General Practice Forward View – to deliver fairer distribution of funding.  We want to achieve this in a way that does not threaten stability and in a way that does not cause financial uncertainty for practices.  

We are now modelling the impact the changes would have on practices in view of other funding flows that are already in train (such as the re-cycling of MPIG and seniority payments and PMS reviews for example).   So, although NHS England and the BMA will now start the detailed negotiations on the new funding formula, we can confirm that we will not seek to implement any changes to the funding formula before 1 April 2018. We believe that this timescale will allow time for better forward planning by practices, better engagement with the profession and patient involvement, if this is required.  

It is recognised that, due to the wide diversity of populations served by GP practices, a national formula will never be able to accommodate the workload needs of all practices.  We know that a number of practices provide services to patient populations that have characteristics that affect the practice’s costs or workload in a way that cannot be captured through a formula. 

Therefore, in parallel to the development of the new national funding formula, we are in the process of developing national guidance for commissioners which will focus on three such population types. This builds on the proposal in the BMA’s Urgent Prescription for General Practice that practices serving atypical populations should be supported through bespoke arrangements. These are:

-          university practices, 
-          unavoidably small and isolated practices, and 
-          practices with a significant proportion of the patient list who cannot communicate in English.

This guidance will illustrate for commissioners the workload challenges that practices face and guide commissioners to relevant data sources or intelligence to assist them in making decisions regarding sustainable support.

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