Becks Fisher Profile picture
Jun 23 4 tweets 3 min read
Great to see @rcgp calling for extra funding for practices in deprived areas as part of 'a comprehensive review of the Carr-Hill formula'.

Hot on heels of @NikkiKF and great news for #generalpractice @deependgp

A reminder of why 🧵👇

pulsetoday.co.uk/news/workforce….
General practice in deprived areas has:

- More demand/higher patient need
- Less funding
- Fewer GPs

Very hard to fix #healthinequalities in the context of inequitable supply.

More on that: health.org.uk/publications/r…
We looked at 30 years of attempts to tackle this #inversecarelaw in general practice.

Since 2004, all attempts have existed in the context of a flawed funding formula.

Hard to 'fix' workforce inequities unless funding is fairer - so action on CH key.

health.org.uk/publications/r…
There will rightfully be a debate about the best way to do this. Bring back deprivation payments? Fix Carr-Hill? Both?

All will be easier if overall funding increases (so avoid a 'losers effect').

Great to see @rcgp @NikkiKF supporting such important change.

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More from @BecksFisher

May 21, 2021
General practice in areas of high deprivation is under-funded and under-doctored relative to need.

Paper out today on why Govt needs to ‘level-up’ general practice & where they should focus.

🧵👇🏻 on evidence for #inversecarelaw in #generalpractice.

health.org.uk/publications/l…
Ppl who live in more deprived areas have greater health need.

-They are more likely to have multiple health conditions

-And they accumulate those conditions at an earlier age.

health.org.uk/sites/default/…

Need is 🔼, so you'd expect there to be🔼supply of health care. BUT.....
💰💰💰

- General practices serving more deprived populations receive less funding than practices serving more affluent ones.

- Once you adjust for need, practices serving the most deprived areas get around 7% less funding than practices in the most affluent areas
Read 10 tweets
May 6, 2021
The last few months in #generalpractice have felt hectic, even by usual #GP standards.

short 🧵👇🏻 looks at what appointment/workforce numbers show, with some thoughts on the important bits that those numbers can't tell us....
1. Total appointment numbers in March were high (28.5m), BUT

2. The number of appointments done by GPs was particularly high (14.7m - the highest since the dataset began).

3. GPs did 2.5m more appointments in March '21 than in Feb (nb there were 3 more working weekdays)
- The absolute number (and %) of F2F appointments is creeping up (15.8m in March) AND

- The number of phone appts in March 21 (11.4m) is also the highest on record.
Read 9 tweets
Jan 13, 2021
Despite rhetoric on #healthinequalities, the current UK #vaccination strategy discriminates against poorer people.

🧵 below on why.

Immediate action needs to be allowing vacc sites to move down cohorts (& providing supply to do so)

@CdsPcn @NikkiKF @CMO_England @Jeremy_Hunt
With the exception of HCWs, the top JCVI cohorts are based on biological age.

But poverty affects life expectancy. In poor areas people don't live so long.
Our #PCN covers a highly deprived area. Most people don't live to be over 80. Or > 75 for that matter. Our first cohorts are tiny.

BUT we have huge numbers of patients in cohort 4 (over 70, and clinically extremely vulnerable). That's b/c we have LOADS of ppl w multimorbidity
Read 9 tweets

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