• Cambridgeshire and Peterborough CCG says award of funding is “over shadowed” by challenging timeframe
  • According to the CCG, the 2016-17 allocation of the ETTF must be spent before the end of this financial year.
  • Some CCGs are unable to fund increased rental costs of premises developments, says BMA official

Commissioners have raised concerns over a national direction to spend the 2016-17 allocation of the primary care estates and technology transformation fund by the end of March, despite it only being allocated in October.

A British Medical Association leader has also warned that practices are struggling to commit to increasing their estate size as some clinical commissioning groups are unable to afford recurring increased rents for ETTF developments. NHS England said in guidance published in May that CCGs need to fund the revenue costs of any bids they submit.



The BMA warned there is risk the fund ‘won’t be used in the most effective way’

In June, CCGs were invited to submit bids on behalf of GPs for the second tranche of the ETTF – formerly the primary care transformation fund. NHS England announced the 300 schemes that would get funding for 2016-17 in October. The first tranche was allocated in 2015-16, after GP practices were invited to submit bids.

In a governing body board paper, published on 1 November, the primary care committee for Cambridgeshire and Peterborough CCG said: “The allocation for 2016-17 [ETTF] must now be spent in this financial year, rather than the previously stated recognition that the scale of premises and technology improvements cannot be successfully completed within the constraints of single and partial financial years.”

The paper also said the requirement to spend the October allocation of the ETTF during 2016-17 affected the first cohort of schemes the CCG was able to put forward for investment – and receiving £7m of funding was “somewhat overshadowed by the complexity of the processes and the challenging timeframes for delivery”.

The document added: “It is to be noted that the majority of investment in cohort one relates to technology transformational bids with a small amount of investment for minor premises improvements that are possible to deliver in the short timeframe. There is greater confidence that the schemes in cohort two will be able to extend across the financial years of 2017-18 and 2018-19.”

Richard Vautrey, an executive member of the BMA general practice committee, said: “I think there is a risk that [the ETTF] won’t be used in the most effective way. CCGs have identified there is further money available next year as well, as this is part of a multi-year fund, but the key is using the resource wisely. We need to see flexibility across years and we can’t just be forced into making the wrong decisions simply to hit a deadline at the end of March.”

Dr Vautrey also suggested practices would struggle to commit to increasing their estate size as some CCGs are not able to cover recurring increased rents for expanded estates due to budget constraints.

“I think the big problem that many practices have got is that this is only capital resource and one of the problems is how they maintain their building because there isn’t any commitment for ongoing increased rental reimbursement from CCGs,” he said.

“In some areas – Leeds has been one – [CCGs] have refused to fund the ongoing rental increase and that limits an ability for a practice to commit to an increase in their property size.

“The problem is the funding isn’t recurrent, so it is the recurrent costs CCGs are concerned about when their budgets are so oppressed at the moment.”

NHS England has been approached for comment.