General medical services allocation formula

Adjusting the general medical services allocation formula to reflect recruitment and retention difficulties in deprived areas

This project contributed to the review by the UK General Medical Services Formula Review Group (FRG) of the funding formula used to pay general practices for essential and additional services. It provided an assessment of the validity of adjusting the formula to reflect recruitment and retention difficulties in under-served areas. The research demonstrated the extent to which working in under-served areas was unattractive to GPs and must be compensated by an earnings premium.

Summary

This research was commissioned to establish whether recruitment and retention difficulties increase the relative costs of service delivery in deprived areas, and therefore whether an adjustment for this in the GMS Allocation Formula is appropriate. The project contributed to the review by the UK General Medical Services Formula Review Group of the funding formula used to pay general practices for essential and additional services. It provided an assessment of the validity of adjusting the formula to reflect recruitment and retention difficulties in under-served areas. The research demonstrated the extent to which working in under-served areas was unattractive to GPs and must be compensated by an earnings premium.

Outcome and Translation

Commissioned by NHS Employers to inform the work of the UK General Medical Services Formula Review Group the research contributed to a revised global sum formula for distribution of funding for General Medical Services in the UK. NHS Employers and the General Practitioners Committee consulted key stakeholders on the recommendations of FRG’s review in early 2007. In their final report the FRG recommended a revised formula that included an adjustment for the Costs of Recruitment and Retention (see page 24 onwards) as recommended by HERU. The HERU research was published in full alongside the FRG’s final report:

UK General Medical Services Formula Review Group (2007) 'Review of the General Medical Services global sum formula', London: NHS Employers.

We understand that negotiations between the Departments of Health and the GPC continue but the report of responses to the consultation raised no objections to our methodology and concluded that “the overall recommendations will now be considered by the Departments of Health as an integral component of future policy development covering primary care.” (p.23 of the summary of response to consultation).

HERU researchers involved in this research project: Robert Elliott, Diane Skåtun, Matt Sutton and Ada Ma.

External collaborators: H Gravelle, AR Hole (University of York); S Morris (Imperial College London) and B Sibbald (University of Manchester)

Publications

Elliott, R., Sutton, M., Gravelle, H., Hole, A., Ma, A., Morris, S., Sibbald, B. and Skåtun, D. (2006) 'Adjusting the General Medical Services Allocation Formula to reflect recruitment and retention difficulties: final report'.

Morris, S., Sutton, M., Gravelle, H., Elliott, R., Hole, A., Ma, A., Sibbald, B. and Skåtun, D. (2008) 'Determinants of General Practitioners' wages in England', Centre for Health Economics Research Paper 36, Centre for Health Economics, University of York.

Morris, S., Goudie, R., Sutton, M., Gravelle, H., Elliott, R.F., Hole, A.R., Ma, A., Sibbald, B. and Skåtun, D. (2011) 'Determinants of General Practitioners' wages in England', Health Economics, 20(2), 147-160.

Presentations

Sutton, M., Morris, S., Elliott, R., Skåtun, D. and Ma, A. (2005) ‘Adjusting the General Medical Services Allocation Formula to reflect recruitment and retention difficulties: progress report’, General Medical Services Formula Review Group, London, September 2005.

Elliott, R., Sutton, M.,Gravelle, H., Hole, A., Ma, A., Morris, S., Sibbald, B. and Skåtun, D. (2006) ‘Adjusting the General Medical Services Allocation Formula to reflect recruitment and retention difficulties’, General Medical Services Formula Review Group. British Library, London, January 2006.

Morris, S., Elliott, R., Gravelle, H., Hole, A., Ma, A., Sibbald, B., Skåtun, D. and Sutton, M. (2006) ‘Mobility of the GP workforce’, Collège des économistes de la santé (CES)-HES., City University, London, January 2006.

Morris, S., Sutton, M., Elliott, R., Gravelle, H., Hole, A., Ma, A., Sibbald, B. and Skåtun, D. (2006) ‘Determinants of GP wages’, Health Economist’s Study Group, York, July 2006.

Sutton, M., Elliott, R., Gravelle, H., Hole, A., Ma, A., Morris, S., Sibbald, B. and Skåtun, D. (2006) ‘Local differences in family doctor recruitment and retention and patterns of relative rewards’, European Conference on Health Economics, Budapest, July 2006.

Elliott, R., Sutton, M., Ma, A., Skåtun, D., Gravelle, H., Hole, A., Morris, S. and Sibbald, B. (2007) ‘Derivation of geographic pay differentials to equalise the recruitment and retention of general practitioners’, International Medical Workforce Collaborative, Vancouver, March 2007.