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Safeguarding patient services, maintaining cost-effectiveness

April 2007

This year's Doctors' and Dentists Review Body (DDRB) report heralded a second year with no increase in funding to GP practices for the core elements of the contract, despite rising costs and inflation. Its decision will put practices across the country under considerable financial pressure. There can be no doubt that GPs’ first priority will be to safeguard patient services from the effects of a reduced practice income. Despite financial pressures they will also wish to continue to reward practice staff fairly.

While it may not be possible to bridge the gap between rising costs and a zero increase in practice income, it is likely that GPs will want to review their practice workload and costs to explore decisions and actions they could take when trying to balance the practice’s books. In much the same way that tight NHS budgets have resulted in pressure on hospitals to review their services, primary care providers will now need to take tough business-minded decisions to minimise the effects on both the practice and patient services. This guidance identifies a number of measures to help practices with their business planning.

On a related note, practices should be aware that many of last year's directed enhanced services (DESs) finished at the end of March 2007 (details can be found at the back of this guidance). To date there has been no discussion about replacing these DESs in England. GPs across the UK are under no obligation to continue to provide the services covered by expired DESs. The General Practitioners Committee (GPC) will keep GPs informed of any developments in this area.