GPs who took on budgets under NHS reform are millions in the red

General Practitioners (GPs) who have taken over budgets from Primary Care trusts (PCTs) under NHS reforms are sliding millions into the red.

According to GP publication Pulse analysis of financial data reported across 55 primary care trusts, two-thirds of shadow clinical commissioning groups (CCGs) reporting figures are currently missing their financial targets.

At present 29% of all PCTs are behind budget for 2011/12 and only 9% predict they will not meet their financial targets by April 2012.

Of the 29 CCGs who provided figures, 66% reported to be behind budget, whilst 4 of the 20 CCGs who make end-of-year forecasts reported they would still be in deficit at the end of the financial year despite having introduced tough measures to achieve their target.

The CCG analysis contained overall financial figures from NHS Cumbria, NHS Cambridgeshire and NHS Northamptonshire.

All or most budgets in these counties are already GP controlled.

NHS West Sussex is amongst the worst hit areas, with the PCT being £15m behind budget and because of overspending on acute care; its two CCGs are £9.1m and £13.6m behind budget.

In other counties NHS Barking and Dagenham are behind budget by a total of £2m. Their constituent CCGs is behind by £2.5m, £1.4m and £106,000 respectively.

Cumbria has initiated a CCG-led recovery plan, which involves 'a number of remedial financial measures.

In total, the net-shortfall for the 29 CCGs with figures amounts to £28m, which translates into an average shortfall per CCG of £967,000.

According to Dr Chaand Nagpaul, a negotiator for the GP committee of the BMA: "Costs are generated through modifications in coding and re-referrals."

He stated that the Government should concentrate on reforming the 'perverse' payment system that has encouraged over-activity.

A Department of Health spokesperson said:
"We do not think this information regarding shadow CCGs' financial positions represents a realistic picture.

"As described in the 2011/12 NHS Operating Framework, we expect PCTs and developing CCGs to work together to ensure that financial control and balance is maintained in 2011/12 and 2012/13.

"The DoH is ensuring organizations forecasting a deficit have plans in place for financial recovery, while continuing to improve the quality of services to patients."