Government Review to Deliver Fairer GP Funding

A six-month review of how GP funding is distributed across England has been launched to ensure that communities with the greatest health needs receive their fair share of NHS resources.

The Department of Health and Social Care and NHS England have announced plans to overhaul the Carr-Hill funding formula, which determines how resources are allocated to GP practices. The review, led by the National Institute for Health and Care Research (NIHR), will examine how factors such as deprivation, population growth and workload pressures can be better reflected in future allocations.

The current formula, which is around 25 years old, has been criticised for failing to keep pace with demographic and social change. The government says the reform will tackle health inequalities by ensuring that funding more accurately follows need, particularly in more deprived and coastal areas.

According to NHS data, GP practices in areas of higher deprivation are more likely to close, leaving residents with fewer doctors and longer waits. Evidence cited in the announcement shows that practices serving more deprived communities receive around 10% less funding per patient than those in more affluent locations, despite having higher demand and more complex cases.

The review will also consider lessons from areas such as Leicester, Leicestershire and Rutland Integrated Care Board, which identified major disparities in current funding distribution when compared to the actual needs of local populations.

Launching the review, Minister of State for Care Stephen Kinnock MP described the current system as “no longer fit for purpose,” saying that the new model will “end the postcode lottery of care” and ensure that investment in general practice reaches the communities most in need.

Dr Amanda Doyle, NHS England’s National Director for Primary Care, said the review would ensure practices serving the most deprived areas “receive a fair share of resources that reflects their need.”

The announcement forms part of the government’s wider 10-Year Health Plan, which places general practice at the heart of a shift from hospital-based to community care. It follows investment of £1.1 billion in general practice, recruitment of over 2,000 additional GPs, and the rollout of online appointment booking to help end the “8 a.m. scramble.”

The review will report its findings in six months and make recommendations on replacing the Carr-Hill formula.

Read the government announcement here

The Rural Reality

While the government announcement highlights deprived and coastal areas, it does not mention rural communities, which face many of the same structural barriers to primary care.

Evidence from Rural England CIC’s State of Rural Services 2025 report shows that people living in rural areas face significantly longer travel times to reach healthcare services. The report found that residents in villages, hamlets and isolated dwellings can face average minimum public-transport journey times of over 70 minutes to access their nearest GP surgery, compared with around 11 to 13 minutes for urban residents. It also noted that the number of hospitals located in rural areas has fallen by around 35% over the past 15 years, and that closures of GP surgeries have increased the distances many rural residents must travel to access care.

The Rural Services Network’s Delivering for All roadmap emphasises the need for public funding formulae that accurately reflect the higher costs of delivering services in rural areas and calls for better metrics to identify hidden deprivation that can be obscured by data designed for urban contexts. It also highlights the importance of ensuring that all national health and care strategies are Rural Proofed, so that residents in villages, market towns and remote communities receive equitable access to essential services.

Rural England also continues to face wider pressures across primary care, including workforce shortages and the closure of local services, underlining the importance of ensuring that this funding review takes rural health inequalities fully into account.

Everyone, no matter where they live, deserves fair and timely access to quality healthcare.