Primary care underspend helps counter trust deficits

Accounts published by NHS England show an underspend of £190.6m for care in the primary care and secondary dental care budget last financial year.

The quarter four finance report for 2016-17, published this week, said commissioners’ actual spend on primary care and secondary dental care was £8.4bn compared to a planned spend of £8.6bn.

This represents 20 per cent of NHS England’s overall underspend of £900m, which helped offset the £791m deficit in the provider sector and contributed to the Department of Health’s overall underspend of £563m.

Every clinical commissioning group was told to hold back 1 per cent of their allocations as part of a “contingency fund”, which NHS England chief executive Simon Stevens said last year was money that “would have been available from CCGs for mental health services, community health services and primary care”.

In March, Paul Baumann, chief financial officer for NHS England, told all CCGs that the full contingency fund would need be used to offset trust deficits.

At the end of 2015-16, NHS England also reported an underspend in primary and secondary dental care of £150m and in 2014-15 had an underspend of £199m.

The news follows HSJ reporting that spending on NHS trusts grew faster than on general practice in 2016-17. The accounts covering NHS England and CCGs said spending on general practice grew by 2 per cent over the last financial year, which is the largest cash terms increase in several years, but in real terms was almost flat.

Gavin Ralston, an executive member of the British Medical Association’s GP committee, said: “GP practices across the country are currently struggling to offer enough appointments and basic services to patients because of a perfect storm of rising workload, stagnating budgets and staff shortages.

“In this toxic environment, it is unacceptable that important resources are not being spent where they are needed – namely to develop and transform GP services, where 95 per cent of consultations within the NHS take place.”

A spokesman from NHS England said: “NHS England continues to invest in primary care. Our core spending by GP services increased by 2.2 per cent in 16-17, 1.4 per cent higher than growth in the previous year…A full reconciliation of general practice spending will be included in the Investment in General Practice Report for 2016-17, which will be published by NHS Digital in September.”

This story was updated 14 August following a statement recieved from NHS England