What does the new budget mean for general practice?

Highlights

There wasn’t much expectation that the budget this week would offer a lot for the NHS, apart from the widely forecast funding for social care. This is a positive outcome, of course, although it is not yet clear how much influence the health service will have over how it is spent. A framework is promised for 2018/19 but not for the coming year, so we will just need to wait and see.

Funding was promised for ‘GPs in Accident and Emergency Departments’ with £100m capital funding to set up GP-run urgent care centres on hospital sites, possibly using a principle similar to the successful Luton and Dunstable model. Details are awaited but as I understand it there is no funding for sessional time and nothing to indicate how the inevitable recruitment challenges will be addressed.

One could be a little paranoid and infer that the government’s priority for general practice appears to be what GPs can do for other parts of the service, rather than how to help general practice itself.

Headlines

The RCGP Chair expressed the view that the money would have been better targeted at measures to improve the sustainability of general practice, and I suspect many GPs would agree with that, but measures to support general practice were absent.

Searching through the headlines on the Budget and on Barcelona’s amazing result in the Champions League, one can find reports that Jeremy Hunt reaffirmed his intention to get back on track with the 4 hour target. This in turn confirms that Emergency Departments are the current priority, and the £100m is aimed at them rather than at general practice per se.

There was nothing to help prevent patients from needing to attend the hospital site in the first place. I guess this is the remit of STPs and so it was not addressed in the Budget (other than a welcome announcement of capital funding to support STP implementation).

Finally, it has been noted that the National Insurance changes will impact on GPs, and will (partially at least) negate some of the increased funding already promised.

All in all, not a budget for general practice. A budget that was not really about health either, although the primacy of the 4 hour target was reaffirmed, and addressed with measures that may be welcomed in some quarters but which could further exacerbate the recruitment challenges in general practice.

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