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CCGs set to be ‘left with little to invest in primary care’

Half of CCGs are expected to report financial deficits at the end of this financial year, which combined are anticipated to exceed £700m.

NHS England board papers said this will come despite £519m worth of budgetary cuts made by CCGs during 2017/18.

And GP leaders have said the deficit puts planned funding increases for GP practices in doubt as CCGs ‘are left with little to invest in primary care’.

The papers state that 95 CCGs are predicting a year-end deficit of £291m on top of other budget risks that amount to £428m, which NHS England says are likely to materialise - amounting to a deficit of £719m. 

At the NHS England board meeting, Paul Baumann, NHS England’s chief financial officer, said the deficits reflect ‘the underlying pressures’ facing the NHS.

He added: ‘It seems likely that most of the risks reported by CCGs alongside their core forecast will crystallise, taking the overspend for the year to over £700m.’

In an effort to fill the gap, NHS England launched a £400m ‘commissioner sustainability fund’ to help CCGs balance their books in 2018/19, which comes on top of a £600m increase to the CCG funding allocations for next year.

According to official guidance on the sustainability fund, CCGs are eligible for a cut of the money if the budget target they have been set by NHS England would still result in a reported deficit at the end of 2018/19. 

NHS England sets budget targets by ‘taking into account each CCG’s financial performance in 2017/18’ with CCGs in deficit expected to reduce their spending ‘by at least 1%’ of their annual funding allocation from NHS England.

Mr Baumann added that the £400m fund is ‘clearly essential if we’re going to have a chance of successful financial management in the year ahead’.

BMA GP committee chair Dr Richard Vautrey said that the deficit was ‘unsurprising’ considering the lack of preparation for winter pressures.

He told sister publication Pulse that the NHS is not being adequately funded ‘to effectively deliver services and given the unpreparedness to face the challenges of the busy winter months, it is unsurprising that many CCGs have run into financial difficulties’.

He said: ‘Ultimately, this is a wider reflection of the funding crisis which has for years been negatively impacting general practice, hospitals and community services.

‘The result is a damaging knock on effect as CCGs are left with little to invest in primary care and community services or deal with the workload pressures facing GPs.’

NHS England revealed last month that the proportion of centrally allocated funding for general practice is set to fall to 7.1% of the total NHS budget in 2018/19, from 7.2% in 2016/17 and 7.3% in 2015/16.