General practice is at risk of losing £33 million this financial year because of an underspend by Clinical Commissioning Groups (CCGs), and potentially up to £760 million by 2020 because of being left out of regional NHS plans, according to the Royal College of General Practitioners.

Sustainability and Transformation Footprints (STPs) are to be produced by every health and care system in England to show how local services will evolve and become sustainable over the next five years. But research by the College has found that, of the 44 STPs it has assessed thus far, few have drawn up plans to boost investment in general practice.

This is despite the government's promise to shift resources into field, and NHS England guidance that STPs should now be drawing up plans to invest up to £760 million of new money into general practice in 2020/21 using the national Sustainability and Transformation Fund.

This fund is currently spent centrally but is set to be shifted to STPs by 2020/21, but the fact that the STP plans have made very little provision for general practice is raising concerns that they will be focussed on acute trust deficits instead.

"The College has strongly supported the formation of the STPs as a critically important new initiative in the NHS that can function as regional engine rooms for a more collaborative approach to shaping services and dealing with challenges, such as the huge increase in multiple long-term conditions within the patient population nationwide," said RCGP chair Dr Maureen Baker.

"The STPs will play a crucial role in shaping the future development of the NHS over the next five years," but "based on the limited information about STPs that has been published, very few contain specific pledges to earmark extra funding for general practice. Some barely acknowledge general practice at all."

The RCGP is now calling on NHS England chief executive "to require all STPs to publish their financial plans, and to make crystal clear that unless they commit to invest more in general practice, through the Sustainability and Transformation Fund, their plans will be rejected and responsibility for the Fund regionally will be withheld from the non-compliant STPs."