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Saturday 18 August 2018
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New funding model needed for general practice, study claims

General practice needs a new funding model to respond to workload and staffing challenges

General practice needs a new funding model to respond to workload and staffing challenges, a study has claimed.
 
NHS England takes into consideration only a limited number of variables considered relevant to workload and staffing when allocating resources, researchers from Oxford, Cambridge and Bristol suggested.
 
Conversely, a study published yesterday (24 April) in the British Journal of General Practice (BJGP) shed light on a new model that could ‘inform the development of more sophisticated staffing models, and resource allocation formulae’.
 
Lead author Toqir Mukhtar of the University of Cambridge said: 'General practice requires a new resource allocation model, and the one we have developed is of greater utility than that currently used by NHS England because we consider the independent effect of six variables not considered in the NHS England model.
 
'Our findings can be used to inform the development of a more sophisticated resource allocation formula which, given the increase in clinical workload, is  required.'
 
Six factors
The researchers argue that the current workload formula in use by NHS England ‘considers the effect of only four variables (sex and age group, rurality, deprivation, and number of new registrations) on the duration of consultation’.
 
Future funding formulas should instead include six further factors: ‘patient ethnicity, smoking status, numbers of GPs, number of nurses, QOF (quality measures) scores, and practice training status’.
 
Lead author Toqir Mukhtar and colleagues obtained data from the Clinical Practice Research Datalink (CPRD) on ‘consultations with non-temporary patients registered for at least one day at an English general practice between April 2013 and March 2014’.
 
After having analysed the increase in consultation rates with GPs and practice nurses in 316 general practices in England, they concluded that the six factors mentioned above were linked to increases in consultation rates.
 
Funding based on local needs
 
A previous study published earlier this year concluded that practices are not receiving funding based on local needs, with modest funding provided for high deprivation and older age.  
 
However, the study published today concluded that their finding could help better identify those practices that need additional support, ‘including infrastructure such as consultation space, because of their predicted higher workload’.
 
It continued: ‘The findings show that practices in areas that have more older patients living in deprived areas (as in some seaside towns), or a higher proportion of patients from Asian ethnic groups, are likely to experience high workload, and this should be accounted for in workforce planning’.