Primary care funding disparities by deprivation
Unfair primary care funding mechanisms that fail to account for deprivation, exacerbating pressures in deprived areas.
159 items
5 sources
Strongest theme matches
Mixed across source types and ranked by classifier confidence plus text match strength.
Committee recommendation
100match
#38 - Revise Carr-Hill formula and PCN funding to better account for deprivation and high need.
NHS England should revise the Carr-Hill formula to ensure that core funding given to GP practices is better weighted for deprivation. NHS England must also review new PCN funding mechanisms to ensure that they do not inadvertently restrict funding for areas which already have high levels of need.
Matched on
terms: care, deprivation, funding
Committee recommendation
100match
#37 - Unfair primary care funding mechanisms exacerbate pressures in deprived areas and entrench regional variation.
It is unacceptable that areas already under significant pressure due to high levels of deprivation, ill health and under-doctoring have these pressures compounded by unfair funding mechanisms which fail to take account of deprivation. It is particularly concerning that new funding mechanisms in the Primary Care Network contract repeat this failing and risk entrenching regional variation in the...
Matched on
terms: care, deprivation, funding, primary
Committee recommendation
98match
#5 - Publish analysis of actual NHS dental care costs, reflecting treatment complexity and community deprivation impacts.
DHSC and NHSE have not undertaken the analysis needed to understand the actual cost of delivering NHS dental care, without which any efforts at reform will fail to address fundamental issues around the affordability of NHS work. The discrepancy between what a dentist can earn delivering NHS work and private work is a fundamental issue for improving access....
Matched on
terms: care, deprivation, disparitie, funding
Committee recommendation
91match
#11 - Pharmacy's potential to improve healthcare access requires substantial public funding and support.
We have been encouraged to hear the enthusiasm within the pharmacy profession to deliver more patient facing care. However, the undoubted potential for pharmacy to improve access to health care, crucially including immunisations, and reduce pressure on general practice and other areas of the health system can only be realised with the right support and the right investment...
Matched on
terms: care, funding
Committee recommendation
86match
#13 - Inadequate CEIAG funding causing significant disparities and gaps in provision for schools.
The Department’s expenditure on CEIAG provision is around £5,000 per school— falling far short of the estimated £38,000 to £76,000 needed to achieve the Gatsby benchmarks. The expectation on schools and colleges to pay for CEIAG out of their already stretched budgets is causing significant disparities in provision, and we have heard that schools are only spending £2...
Matched on
terms: care, disparitie, funding
Committee recommendation
82match
#75 - Undertake comprehensive review of National Funding Formula to ensure fair, needs-based allocation.
A comprehensive review of the National Funding Formula is urgently needed to ensure funding is allocated fairly and reflects the real level of need across the country. The current formula fails to address historic underfunding, ignores rising inflation, does not account for regional differences in cost and need and ignores hidden pockets of deprivation. These gaps are driving...
Matched on
terms: deprivation, funding
Committee recommendation
78match
#17 - NHS funding mechanisms create perverse incentives, disadvantaging deprived areas for childhood vaccinations.
We asked about the equity of NHS funding mechanisms and the risk of perverse incentives, using as an example the distribution of money for childhood inoculations. GP surgeries receive a payment for every child that gets a vaccine.29 In our view, this funding mechanism favours wealthier areas where parents are more willing to inoculate their children. At the...
Matched on
terms: funding
Committee recommendation
78match
#2 - Overhaul the Community Pharmacy Contractual Framework to address funding gaps and reduce complexity.
We recommend that the Community Pharmacy Contractual Framework (CPCF) is completely overhauled, in close consultation with the community pharmacy sector. Any new framework must: a) close the gap in funding that community pharmacy has experienced over the course of the current CPCF; b) focus on reducing complexity and ensure pharmacy owners can clearly understand and predict their cash...
Matched on
terms: care, funding
Committee recommendation
78match
#17 - Second Report - Long-term funding of adult social care
The geographical inequity of relying on council tax to provide the majority of funding for adult social care is compounded by an out-of-date adult social care relative needs formula. The Government must update the adult social care relative needs formula by the next financial year. This should be implemented alongside the Fair Funding Review and council tax equalisation....
Matched on
terms: care, funding
Committee recommendation
77match
#11 - Twenty-First Report - School Funding
The Department also highlighted the impact of the new minimum per-pupil funding levels on the distribution of funding. The effect of these had been to shift funding in the direction of schools that had very low levels of deprivation.12 The Department told us that it had always known that the minimum funding levels were likely to benefit the...
Matched on
terms: deprivation, funding
Committee recommendation
77match
#10 - Twenty-First Report - School Funding
The Department told us that funding allocations were now catching up with changing levels of deprivation—some areas remained very deprived but were not as deprived as they had been in the early 2000s, while other areas remained less deprived but were significantly more deprived than they had been. This situation had created what on the face of it...
Matched on
terms: deprivation, funding
Committee recommendation
77match
#13 - Competitive bus grant allocation leads to unequal funding, failing to consider rurality.
The Department’s decision to allocate some grants competitively has meant funding per person varied significantly. On average, mayoral combined authorities received significantly more bus service improvement funding (£34 per person) than county councils (£19 per person).27 We asked the Department how it was going to make its funding fairer. The Department told us that it is now using...
Matched on
terms: deprivation, funding
PFD report
73match
Samuel Brown
The primary care prescribing regime failed to identify potential addiction and drug-seeking behaviour, and neglected to review medications for ongoing necessity.
Matched on
terms: care, primary
Committee recommendation
73match
#2 - Twenty-First Report - School Funding
Under the national funding formula, schools that are more deprived have fared worse than those that are less deprived. In 2018–19, the Department introduced a national funding formula with the aim of allocating school funding more transparently, consistently and fairly across the country. The new formula has made allocations more transparent and consistent, but it has also led...
Matched on
terms: deprivation, funding
Committee recommendation
72match
#1 - Northern Ireland's public services remain in crisis across health, education, and justice.
Northern Ireland’s public services remain in crisis. Its health service is under immense pressure, with long waiting lists, a struggling primary care sector and an acute mental health situation, in part due to Northern Ireland’s recent history. There are severe demands on the education sector, too, with SEN pupils suffering and schools operating with large deficits. Policing and...
Matched on
terms: care, funding, primary
Committee recommendation
70match
#11 - Deprived communities and minority groups experience longer elective care waiting times
In July 2025 NHSE started publishing new data alongside the existing monthly Referral to Treatment Waiting Times data that showed that people from deprived communities and minority backgrounds are more likely to be waiting longer than 18 weeks for care than other groups.19 NHSE told us that one of the challenges it faces is ensuring equity of access...
Matched on
terms: care
Committee recommendation
69match
#4 - Review NHSE payment systems and processes to incentivise local systems supporting hard-to-reach patients.
In some cases, NHSE’s payment mechanisms can mean that local systems do not receive financial recognition when they prioritise hard-to-reach patients. GP surgeries receive a payment for every child vaccination. This vaccination funding mechanism favours areas where parents are more willing to inoculate their children, while areas with higher levels of vaccine hesitancy, which may be more deprived...
Matched on
terms: funding
Committee recommendation
69match
#3 - Twenty-First Report - School Funding
It is not possible to tell whether individual academy schools are receiving the government’s guaranteed minimum per-pupil funding levels. In 2018–19, the Department introduced minimum levels of schools block per-pupil funding for all schools in England. In January 2020, the Prime Minister guaranteed that every school would receive minimum funding of £3,750 per primary pupil and £5,000 per...
Matched on
terms: funding, primary
Committee recommendation
69match
#20 - Provide detailed statement on NHS funding allocation formula for rural mental health needs.
We welcome the Government’s commitment to provide more funding for mental health and to ensure local mental health spending increases by the same proportion as overall increases in local health funding. Despite this, we are concerned by the possibility that the system used by NHS England to allocate funding fundamentally disadvantages rural areas. The Government’s settled view is...
Matched on
terms: deprivation, funding
NAO recommendation
69match
Introducing Integrated Care Systems: joining up local services to improve health outcomes
c) by April 2023, NHSE should set out plans to identify unavoidable cost differences in the provision of healthcare by different trusts and take account of them in the formula for allocating funding to ICBs. This should include a timetable for addressing them and changes it has made to the 2023-24 allocation process;
Matched on
terms: care, funding
Committee recommendation
65match
#13 - Significant regional disparities observed in energy support voucher redemption rates.
We asked witnesses about the take-up rates for the vouchers. The Department told us that 76% of vouchers had so far been redeemed across Great Britain. It accepted that take- up was lower in metropolitan areas, and that the take-up rate was just 60% in London.29 The NAO found that the Department believed that voucher redemption was likely...
Matched on
terms: disparitie
Committee recommendation
65match
#29 - Outdated police funding formula creates structural gaps for forces amid demographic changes since 2015.
In its 2015 report on the financial sustainability of police forces, our predecessor Committee recommended that a new police funding formula be introduced in 2016–17.80 In our evidence session, we asked whether changing demographics meant the out-of-date formula had led to a structural funding gap.81 We were also concerned about the impact on rural police forces.82 Demographic changes...
Matched on
terms: funding
Committee recommendation
65match
#5 - Permanently apply ringfence to prevent diversion of NHS dental funding by ICBs
We welcome the fact that to try and address the underspend, NHS England is applying a ringfence for 2023/24, to ensure that no ICB can divert funding away from NHS dentistry. We recommend that this ringfence applies permanently, and NHS England puts in place transparent scrutiny to ensure compliance.
Matched on
terms: care, funding
Committee recommendation
64match
#25 - Ninth report - Clearing the backlog caused by the pandemic
We recommend that NHS England, together with ICBs and the new Office for Health Improvement and Disparities (OHID), work together to deliver regional and national coordination as the system tackles the backlog in elective care. If the independent sector is to prove an effective partner in tackling that backlog, the Government must ensure that plans take into account...
Matched on
terms: care, disparitie
PFD report
61match
Dean George
Welsh prisons lack an integrated treatment system, failing to automatically offer opiate substitution therapy to new arrivals addicted to opiates, creating an inequality in healthcare provision compared to England.
Matched on
terms: care
Committee recommendation
61match
#74 - Ensure National Funding Formula provides fair, sufficient SEND funding reflecting regional need.
The National Funding Formula must ensure that funding for SEND is both fair and sufficient to meet the needs of children and young people across the country. While some geographical variation is to be expected, this should reflect the prevalence and relative level of need in each area. The formula must guarantee that all local areas are equipped...
Matched on
terms: funding
Committee recommendation
61match
#7 - Twenty-First Report - School Funding
There has also been a relative re-distribution of funding from more deprived schools (those with a higher proportion of pupils eligible for free school meals) to less deprived schools. Between 2017–18 and 2020–21, average per-pupil funding for the most deprived fifth of schools fell in real terms by 1.2% to £5,177, while funding for the least deprived fifth...
Matched on
terms: funding
Committee recommendation
61match
#31 - NHS dental workforce maldistribution creates shocking regional inequalities in access to care.
It is also clearly the case that NHS dental workforce issues are much more pronounced in some parts of England than others and that this is leading to some shocking regional inequalities in access to dental care.92 At the lowest end of the scale, Somerset ICB delivered 382 courses of treatment per 1,000 people in the region, whereas...
Matched on
terms: care
Committee recommendation
61match
#69 - Uprate £6,000 SEND funding threshold annually and establish sustainable, equitable funding model
The current £6,000 notional threshold is outdated and inadequate. It must be automatically uprated each year in line with inflation to prevent further erosion of support for pupils with SEND. This is a necessary correction to address years of chronic underfunding. This funding should also be ringfenced to ensure it is used exclusively for supporting pupils with SEND...
Matched on
terms: funding
NAO recommendation
61match
School funding in England
We recommend that the Department should take the following actions: a) Evaluate the impact of the national funding formula and minimum funding levels over time and use that information to inform whether further action is needed to meet its objectives. In particular, the Department should review whether the shift in the balance of funding from more deprived areas...
Matched on
terms: funding
Committee recommendation
60match
#14 - Ninth report - Clearing the backlog caused by the pandemic
As part of its national health and care recovery plan, we recommend that the Government sets out the contribution that public health services will make, and ensures that this contribution is backed with a level of funding that acknowledges their crucial role.
Matched on
terms: care, funding
Committee recommendation
60match
#30 - First Report - The forgotten: how White working-class pupils have been let down, and how to...
School funding has failed to keep pace with where deprivation is in the country, and as a result schools serving disadvantaged communities, including disadvantaged White communities, have suffered financially. The National Funding Formula promises to correct this, but the formula’s changes have not yet been fully enacted, and we have seen concerns that a “levelling up” funding uplift...
Matched on
terms: deprivation, funding
PFD report
57match
Freda Lennox
Inadequate pre-operative assessment stemmed from uncompleted tests, poor information sharing between consultants, and a lack of funding and resources for a dedicated high-risk anaesthetic clinic.
Matched on
terms: funding
PFD report
57match
Kathleen Booth
A significant delay in critical surgery was caused by NHS-wide understaffing, underfunding, and limited weekend cover, disadvantaging patients with injuries sustained on Fridays.
Matched on
terms: funding
PFD report
57match
Barry Myers
Insufficient funding prevents the provision of urgent mechanical thrombectomy services between 4 pm and 8 am at University Hospitals Sussex NHS Foundation Trust.
Matched on
terms: funding
Committee recommendation
57match
#43 - Insufficient funding and support hinder educational outcomes for disadvantaged post-16 students.
On average, economically disadvantaged students aged 16–19 do not perform as well as their peers or achieve the same educational outcomes. Per-pupil funding drops sharply after the age of 16, creating a cliff edge that limits support for disadvantaged students. Existing bursaries for disadvantaged students aged 16–19 are insufficient and inconsistently distributed. There is compelling evidence for the...
Matched on
terms: funding
Committee recommendation
57match
#46 - Develop funding and training strategy to address insufficient LARC provision in general practice.
The Government should develop a funding and training strategy to address the lack of LARC provision in general practice, particularly in those areas not covered by a women’s health hub. This should include an assessment of whether the current fee structure is fit for purpose. (Paragraph 164) Research
Matched on
terms: funding
Committee recommendation
57match
#20 - Ringfencing of Homelessness Prevention Grant funding may detrimentally impact some local authorities.
We welcome the Government’s decision to increase homelessness funding for 2025/26, including the £192.9 million uplift to the Homelessness Prevention Grant (HPG). However, the decision to ringfence 49% of HPG funding for activities to prevent and relieve homelessness may be a detrimental, one-size-fits-all approach towards the pressures facing some local authorities. The ringfence may leave a gap in...
Matched on
terms: funding
Committee recommendation
57match
#8 - Concerns raised over NHS dental contract's UDA rates, incentives, and uncompetitive funding.
In the written evidence submitted to our inquiry, concerns included that: • UDA rates are linked to the figures used in 2006 which no longer reflect current need.13 Rates vary from practice to practice so dentists in the same location may be paid different amounts for the same work; 14 • the contract is rooted in ineffective incentives...
Matched on
terms: funding
Committee recommendation
57match
#68 - Current funding for SEND inclusion and £6,000 threshold remain significantly inadequate
It is clear that the current levels of funding provided to schools and multi- academy trusts are inadequate to support the effective inclusion of pupils with SEND. The notional £6,000 threshold is insufficient to deliver good SEN support, placing unsustainable pressure on school budgets. The Department cannot reasonably expect inclusive education to be realised without a significant increase...
Matched on
terms: funding
NAO recommendation
56match
Supporting disadvantaged families through free early education and childcare entitlements in England
The Department should identify how it can best incentivise the provision of sufficient high-quality entitlement places in deprived areas. This should include reviewing the effectiveness of the existing supplement arrangements and establishing why local authorities are making only limited use of them. The Department should also explore how to encourage providers to offer flexible provision to meet the...
Matched on
terms: care
Committee recommendation
56match
#13 - Ninth report - Clearing the backlog caused by the pandemic
The pandemic has had a negative impact on health inequalities and highlighted the crucial importance of effective public health services in supporting local populations. Public health services are therefore vital allies in tackling the backlog, and we are surprised at the decision merely to maintain current public health grant funding levels.
Matched on
terms: care, funding
Committee recommendation
56match
#19 - Create new Establishment Payment for community pharmacies to develop patient consultation spaces.
We recommend the creation of a new “Establishment Payment” to be paid to eligible community pharmacies to support the development of consultation spaces for patients. This funding should be targeted at pharmacies that are the most reliant on NHS work as their main source of income and could be linked to a commitment to provide an agreed level...
Matched on
terms: care, funding
Committee recommendation
53match
#20 - Provide free over-the-counter medication for low-income patients through Pharmacy First scheme.
To avoid patients continuing to use GPs for support that could be offered in a community pharmacy setting because of concerns about the affordability of over-the- counter medication, we recommend that such medication is free for people on low incomes, as part of the Pharmacy First scheme.
Matched on
terms: care
Committee recommendation
53match
#56 - Colleges face significant challenges due to limited and inequitable capital funding.
Colleges face significant challenges due to limited and short-term capital funding. Whilst recent allocations have addressed urgent maintenance needs, the lack of sustained capital investment prevents long-term improvements. The £300 million allocated for 2025–26 is insufficient given the scale of need across thousands of college buildings. Furthermore, access to capital funding is inequitable, with specialist colleges and sixth...
Matched on
terms: funding
Committee recommendation
52match
#33 - First Report - The forgotten: how White working-class pupils have been let down, and how to...
The Department must also acknowledge that due to funding pressures 34% of headteachers are using the premium to plug financial gaps in other parts of their operation. We note the Department’s recent changes to the conditions of the pupil premium grant, but in the light of the Sutton Trust’s findings about the number of schools using their grant...
Matched on
terms: funding
Committee recommendation
52match
#35 - Home Office failed to achieve equitable asylum distribution targets, lacking credible plan
The Home Office has failed to achieve its targets for an equitable distribution of asylum seekers. Asylum accommodation is still heavily concentrated in particular areas, often areas of high deprivation. Many local authorities do not have faith that the department will achieve a fair and equitable distribution of accommodation. The Home Office has failed to ensure providers deliver...
Matched on
terms: deprivation
Committee recommendation
48match
#32 - First Report - The forgotten: how White working-class pupils have been let down, and how to...
The Department must do more to target funding to address attainment gaps, such as that which persistently affects disadvantaged White pupils. This should begin with reform to the pupil premium, which should be weighted to account for persistent disadvantage, including in disadvantaged White communities, in line with our recommendation on better measures of disadvantage. The Department must also...
Matched on
terms: funding
LGO / SPSO decision
46match
PSOW-202305989 - Cwm Taf Morgannwg University Health Board
An Advocate complained on behalf of Mrs A regarding the care that her daughter, Ms B, received from Cwm Taf Morgannwg University Health Board (“the First Health Board”) and another health board (“the Second Health Board”) in 2022. Specifically, Mrs A complained about the manner in which the funding request for Ms B’s surgery was administered by the...
Matched on
terms: care, funding
LGO / SPSO decision
46match
PSOW-202307570 - Cardiff and Vale University Health Board
An Advocate complained on behalf of Mrs A regarding the care that her daughter, Ms B, received from another health board (“the First Health Board”) and Cardiff and Vale University Health Board (“the Second Health Board”) in 2022. Specifically, Mrs A complained about the Second Health Board’s communication with her and the First Health Board about the funding...
Matched on
terms: care, funding