NHS funding per GP appointment will fall by 28% in nine years

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A tweet by NHS consultant oncologist Clive Peedell led me to some data on the funding for GP services in the NHS and the demand that there is for them.

The data is to be found in a Royal College of GPs press release from 2014 referring to a report they had commissioned from Deloitte.

Using this data and the assumptions I note below the funding per GP consultation in England has, or will, change as follows over a period of a little less than a decade:

Screen Shot 2016-01-06 at 09.28.19

Let me be clear how I worked this.

The prices are constant 2014-15 data and so are directly comparable.

I assumed the real terms budget for the NHS in 2017-18 would be the same as that in 2015-16, which is fair.

The data on number of GP consultations comes from the RCGP.

The RCGP data is for England: I assumed the English budget for GP services is a constant ratio to the total GP budget over the period. This may not be precisely accurate, but is unlikely to make any significant difference at all.

I assumed the GP proportion of the NHS budget was the same in 2008/09 as it was in 2012/13 as I could not see alternative data for that.

What is clear is that, first of all, there is a massive increase in demand for NHS GP services. The data is real from 2008/09 to 2012/13: there is no reason to doubt the trend given the decline in other services available to the public.

Second, as the RCGP have pointed out, there is a real decline in the proportion of a relatively modestly increasing overall NHS budget now being allocated to GP services.

And the outcome is that GPs are now, in real terms, going to be given just 72% of the funding they had in 2009/09 for each visit in the future, or have to be 38% more efficient.

Since time with a patient, or working more hours, is just about the only variable available to a GP, it’s not hard to see how the quality of GP services is declining, patients are losing out and that there are more and more GPs quitting, leading to a crisis in GP services as more and more practices have to close their lists to create safe working conditions.

To put it another way, austerity simply does not work, especially if you care.