GP Funding, Tirzepatide Concerns & Premises Investment: News Update

LIVERPOOL, 2025-06-25

Doctors call for overhaul of medical regulation

The BMA wants a new regulator, saying the GMC isn’t protecting patients.

• BMA calls for a new medical regulator to replace the GMC.
• GPs anticipate a surge in patient requests for the weight-loss drug tirzepatide.
• Government considering private funding for GP infrastructure.
• Changes are coming to how GP funding is distributed.

The British Medical Association (BMA) is advocating for a new medical regulator as the General Medical Council (GMC) is supposedly failing to protect patients and support doctors.

BMA demands a new regulator

The BMA has officially called for a new medical regulator, stating that the current GMC is failing both patients and doctors. According to a poll by the doctors’ union,82% of BMA members support creating a new regulatory body focused solely on doctors. Furthermore, over 61% expressed a lack of confidence in the GMC’s ability to protect the public.

Did you know?-The General Medical Council (GMC) is responsible for registering, licensing, and regulating doctors in the UK. It sets the standards for medical education and training, and investigates complaints against doctors.

During a keynote speech at the BMA annual representative meeting in Liverpool, BMA chair Professor Phil Banfield announced the launch of a new BMA register “solely for doctors.” Banfield criticized the GMC’s approach to regulating physician associates, which he believes has led to ‘incessant and unsafe blurring of professional boundaries that threaten the very foundations of practising medicine’ and ‘what it means to be a doctor’.

Tirzepatide Troubles?

General practitioners (GPs) are bracing for a potential flood of complaints from patients seeking access to tirzepatide, a weight-loss medication. Many practices may not be able to offer the drug until weeks or months after the widely publicized deadline.

Reader question:-With the increasing demand for weight-loss medications like tirzepatide, how can healthcare systems ensure equitable access and prevent further strain on already burdened GP practices?

NHS commissioning guidance indicates that Integrated Care Boards (ICBs) should cover the costs of tirzepatide (mounjaro) for obesity in primary care settings starting June 23, 2025. However, some ICB areas haven’t yet finalized arrangements for practices to refer or prescribe the medication. GPs report a spike in appointment bookings from patients after media reports stated the drug was “now available” from general practices.

Private Funding for Public Infrastructure?

The government is exploring public-private partnerships to fund new primary care infrastructure. These proposals have sparked “serious concerns” among GP leaders.

The government’s 10-year infrastructure plan suggests exploring ‘the feasibility of using new public-private partnership (PPP) models…in very limited circumstances where they could represent value for money’. This could include funding for ‘certain types of primary and community health infrastructure’. A decision on whether to proceed with PPPs in these limited cases is expected by this year’s autumn budget.

Pro tip:-When considering public-private partnerships, carefully evaluate long-term costs, potential impacts on service quality, and ensure robust oversight mechanisms are in place to protect public interests.

GP leaders have cautioned that while practice premises desperately need new funding, any decision to pay for upgrades through PPP must avoid repeating the mistakes of past private finance initiative (PFI) schemes.

GP Funding Formula Faces Overhaul

The government plans to introduce “major changes to how GP funding is distributed” as part of its upcoming 10-year health plan. These reforms aim to address underfunding and GP shortages in underserved areas.

Health and social care secretary Wes Streeting stated that changes to GP funding distribution would ‘help working class communities and coastal areas’ and are part of broader NHS plans to allocate billions of pounds to deprived parts of England. Streeting also mentioned a review of the Carr-Hill formula,which is used to allocate funding to GP practices. The aim is to address inequalities where GP surgeries serving working-class areas ‘receive on average 10% less funding per patient than practices in more affluent areas’ and have considerably more patients per GP.

GPs and NHS leaders have generally welcomed the plan but cautioned that the overhaul should not simply redistribute existing funding between practices.

As the BMA lobbies for a new medical regulator, concerns about the existing structure within the NHS extend beyond just the GMC. The potential for private funding of GP infrastructure highlights a looming debate: how can the NHS modernize while remaining accessible and equitable? Let’s explore this critical issue further.

The Promise and Peril of Public-Private Partnerships

The government’s proposal to explore public-private partnerships (PPPs) has stirred anxieties amongst GP leaders,echoing the concerns around the previous private finance initiative (PFI) schemes.ppps, in theory, offer a way to inject investment into vital infrastructure, like new GP surgeries or upgraded equipment. But are these partnerships the solution?

PPPs can offer notable access to capital, allowing for the rapid construction or refurbishment of facilities. They can also transfer some of the financial risk away from the public sector, especially during the construction phase. Though, this option carries risks.

The long-term costs associated with PPPs can be substantial, locking the NHS into contracts that may not represent value for money over time. Moreover, the involvement of private companies raises the question of prioritizing profits. This could perhaps impact service delivery,potentially affecting patient care if not carefully managed. Remember older Private Finance Initiative projects?

Public-Private Partnerships: Pros & Cons

• Pros:
  • Access to capital for infrastructure upgrades.
  • Risk transfer from the public sector.
  • Faster project completion.
• Cons:
  • Higher long-term costs.
  • Potential impact on service quality.
  • Risk of prioritizing profits over patient care.

Avoiding past Mistakes

GP leaders are rightly cautious, given the history of PFI schemes. These initiatives often resulted in high costs and restrictive contracts, sometimes diverting funds from frontline services. The BMA has already expressed significant concern. Past PFI projects burdened the NHS with hefty repayments and limited adaptability.

Government plans to fund GP infrastructure through public-private partnerships raise serious concerns about long-term costs and potential impacts on service quality. To avoid the pitfalls of past PFI schemes, robust oversight mechanisms are crucial when the NHS works with private partners. This involves careful scrutiny of contract terms, ensuring that the interests of patients and the public are prioritized throughout the project lifecycle.

A obvious procurement process, with open competition and clear evaluation criteria, is also essential. Moreover, contracts must include performance-based incentives, tying payments to the delivery of high-quality services.

Funding Formula Fight: Levelling the Playing Field

Alongside infrastructure concerns, the government’s plan to overhaul GP funding distribution merits close examination. The goal is to address inequalities where funding doesn’t match the needs of different communities. The current funding formula, the Carr-Hill formula, allocates funds to GP practices. However,it’s been criticized for not fully accounting for patient needs in areas with high levels of deprivation.

The proposed reforms aim to distribute money more evenhandedly and help working-class communities. A revised funding model should consider factors like patient demographics, levels of deprivation, and the unique healthcare challenges faced by local communities.

Key Considerations for Funding Reform

• Needs-Based Allocation: Ensure funding formulas accurately reflect the needs of the populations served, rather than rewarding practices in affluent areas.
• Addressing Deprivation: Increase funding to practices in areas with higher levels of social deprivation.
• Workforce Incentives: Provide financial incentives to attract and retain GPs in underserved areas.
• Clarity and Accountability: Establish clear metrics to assess the impact of funding changes.

The government’s plan to reform GP funding distribution seeks to allocate funds more equitably, aiming to support working-class communities and coastal areas. However, it’s critical that any changes don’t just redistribute funds and result in underfunding for practices that already struggle.

Frequently Asked Questions

Q: What is the Carr-Hill formula?

A:The Carr-Hill formula is a system the NHS uses to allocate funding to GP practices based on various factors.

Q: Why is the Carr-Hill formula being reviewed?

A: It is indeed being reviewed as it’s believed to not adequately account for the needs of deprived communities, leading to funding inequalities.

Q: What are public-private partnerships (PPPs)?

A: PPPs involve collaboration between the government and private companies to fund and deliver public projects, such as infrastructure.

Q: What are the potential risks of PPPs in healthcare?

A: Risks include higher long-term costs, potential impacts on service quality related to profit motives and a lack of flexibility.

Q: How can the NHS ensure equitable access to drugs like tirzepatide?

A: Healthcare systems must develop clear prescribing guidelines, address potential supply issues, and monitor access to prevent inequities.