Most deprived areas worst hit by real-terms GP funding cuts

A new study has found that so-called funding increases for general practice amount to significant cuts in real terms after accounting for inflation, with the worst effects seen in the most deprived areas.

Although it has long been recognised that NHS general practices serving the most deprived populations are relatively underfunded, an updated analysis is needed at a time when the Government is implementing its 10 Year Health Plan.

Using published data, a study in the British Journal of General Practice (BJGP) analysed trends in practices' NHS payments between 2019 and 2024 and their association with deprivation, after adjusting for geographical, population and organisational factors.

The analysis found that overall, NHS practice payments were 9–12% below inflation – a real terms funding cut. Although funding trends were slightly better as deprivation increased, the actual amounts involved were very small (and thus of little help), and these gains flattened for the most deprived practices, and for practices in urban areas or with higher numbers of patients with long term conditions.

Furthermore, practices with already higher payments in the past gained more funding than those with historically lower payments.

The funding gaps between deprived and affluent areas have hardly narrowed and inequalities in distribution persist, with no sign of future improvement, the researchers say.

The Carr-Hill formula (the current weighting formula), which aims to compensate practices with higher workloads, is currently under review. Any ‘fixes’ must include better adjustments for deprivation and illness in practice populations, the authors conclude.

There may also be scope to extend weighting to other NHS payment streams, such as those that are performance-related, and to increase the proportion of funding controlled by local NHS bodies, who are likely to have closer knowledge of their practices and the populations they serve.

Levine LS, et al. Br J Gen Pract 2026; DOI: https://doi.org/10.3399/BJGP.2025.0498