Revealed: Social enterprises now dominate GP out of hours sector

Submitted by Sarah Fletcher on Fri, 15/06/2018 - 11:51

This article was published by Rebecca Thomas, HSJ on 8th June 2018:

Revealed: Social Enterprises now dominate GP out-of-hours sector

  • Two thirds of GP out of hours services are now delivered by social enterprise companies
  • However, figures suggest social enterprises receive less funding per patient for these contracts compared to NHS and commercial organisations 
  • Out of hours contracts delivered by NHS organisations have decreased by nearly half in 10 years
  • Social enterprise representative warns providers are being “hobbled” by long term underfunding

Most out of hours GP services are now delivered by social enterprise companies which are being “hobbled” by long term underfunding, according to a representative body.

A new analysis carried out by Urgent Health UK, an organisation representing out of hours providers, has revealed that social enterprises now deliver services to 67 per cent of patients in England.

It said this cohort of providers also receives the lowest amount of funding per patient compared to NHS organisations and commercial providers also delivering out of hours services.

It comes following concerns raised by Social Enterprise UK last week that the government may not fund social enterprises delivering NHS services to implement a pay increase for their staff in line with the national pay deal.

However, one senior source within the sector told HSJ it does not use agenda for change contracts as they are “too expensive and…perverse” and have “automatic uplifts when our contracts do not.” 

The figures, shared with HSJ, show the overall value of out of hours contracts held by social enterprises in April 2018 was £294m, covering 67 per cent of patients.

This share has increased gradually over 10 years, from around 40 per cent in 2008. The share delivered by NHS organisations has declined gradually over the same period, from 30 per cent to 18 per cent. The proportion delivered by commercial providers dropped from 30 to 15 per cent.

According to UHUK, the average funding per patient for contracts held by social enterprises is £7.62, while NHS organisations receive £8.10 and commercial organisations £8.22.

Simon Abrams, GP and chair of UHUK, said in a statement: “It is my impression that when it comes to funding OOH providers, commissioners are often keen to keep costs to a minimum. Funds to enable services to recruit GPs and nurses at a market rate are restricted.

“There has been long term underinvestment in commissioned out of hours services with little regard to national issues such as uplifts or recruitment problems.

“Along with the GP recruitment crisis, the approach has resulted in hobbled OOH services. If they were properly funded, more could soak up care needs and prevent patients with urgent primary care problems attending emergency departments and being admitted.”

In a statement to HSJ, Julie Wood, chief executive of NHS Clinical Commissioners said: ”Although at first glance the reported difference in funding between NHS, commercial and social enterprise providers may seem like a potential cause for concern, this could be due to a number of reasons, such as different levels of overhead or running costs, for example.

“The first priority of clinical commissioners is to deliver the best possible services for their patients and local populations, and they will use a range of approaches to ensure that the services they commission are appropriate and effective for the populations they serve and that the funding allocated is able to deliver the right outcomes.”