NHS funding fosters health inequalities

Poverty and deprivation are strongly associated with poor health outcomes, including higher levels of multimorbidity and mortality, resulting in greatly increased workloads for general practitioners working in deprived areas. According to the Inverse Care Law, those most in need of medical care are least likely to receive it.

NHS funding formulae for calculating payments to GPs are designed to compensate for increased workload, but do not include weightings for specific measures of deprivation. There are long-standing concerns that, as a result, many practices serving very deprived areas are inadequately funded to meet the greater health needs of their populations.

Louis Levene and colleagues in the Department of Health Sciences at the University of Leicester analysed NHS payments to English general practices between 2013 and 2017 to determine whether these payments have increased more in practices with higher measures of deprivation (according to the Index of Multiple Deprivation).

They found only very slightly higher rates of increase for the most deprived practices. This suggests that the current payment formulae are very unlikely to lead to a more equitable allocation of NHS practice funding.

It raises the question of what the payment system is really intended to achieve and, indeed, what the NHS’s priorities are, given the persistent and wide disparities in health outcomes between the more and less privileged, and the potential for additional resources to begin to address these inequities.

Their study, ‘Socioeconomic deprivation scores as predictors of variations in NHS practice payments: a longitudinal study of English general practices 2013–2017’, is available to read online now in the British Journal of General Practice.