Lead paragraph

 

Health Secretary Wes Streeting has ordered a review of the Carr-Hill formula, the mechanism underpinning how GP practices are funded in England, amid mounting evidence that it no longer reflects population need or modern service delivery models.

The review will examine whether current weightings fairly resource practices serving high-demand or deprived communities.

 

Context paragraph

The Carr-Hill formula, introduced in 2004, allocates core GP funding based on factors such as patient age, sex, and rurality. Critics argue that it undervalues deprivation, multimorbidity, and the complexity of urban practice populations. Analysis from the Nuffield Trust and the Health Foundation has repeatedly shown that practices in poorer areas receive less funding per patient despite greater workload intensity. With the government’s 10-Year Health Plan emphasising equity and access, ministers have called the formula “no longer fit for purpose.”

Quote / analysis

“The current system fails to account for the full burden of chronic disease and social complexity,” said a senior NHS England primary care lead. “If we want genuine prevention and continuity, funding must follow need rather than postcode.”

Professional bodies, including the BMA’s GP Committee, have welcomed the review but cautioned that any redistribution must be phased to avoid destabilising practices in better-funded regions.

Implications for operations

For commissioners and system planners, a funding reset could have material implications:

• Workforce distribution: adjustments may prompt renewed focus on GP recruitment and retention in under-doctored areas.
• Primary care networks (PCNs): new weighting could reshape ARRS staffing allocations and integrated community workforce design.
• Financial planning: ICBs may need to reprofile budgets across neighbourhoods, with transitional protection likely required.
• Access and capacity: short-term turbulence is possible as practices adapt to new funding signals and service expectations.

ProMedical View

“The proposed review is a necessary modernisation. Over two decades, population health profiles, multimorbidity, and workforce dynamics have shifted considerably. Aligning funding to real need can only improve equity of access and continuity of care—but it will also expose local capacity gaps. In the short term, systems will require flexible workforce solutions to stabilise primary care coverage during redistribution. Temporary and sessional staffing, if strategically deployed, can help maintain patient access while new baselines are embedded.”

Closing line

Revising the GP funding formula represents more than an accounting exercise—it will determine how effectively England’s primary care system can deliver equitable, prevention-focused care over the next decade.

References

HSJ – “Government orders review of ‘outdated’ GP funding formula” (October 2025).

• Health Foundation – “Rebalancing primary care funding for fairness and need” (2025).
• Nuffield Trust – “How general practice funding reflects (and misses) population need” (2024).