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Extra patients can be costly

The new contract means GPs in rapidly expanding practices cannot expect extra funding to match the number of patients they are taking on, the GPC has conceded.

In new guidance to practices, Financial Implications of Increasing List Size, it advises GPs to get compensation from PCTs if they are forced to take on patients.

The 'worst possible scenario' for GPs is where a nearby small practice closes and they are allocated patients by the PCT, the guidance stated.

Global sum and QOF income rises would not be enough to pay for extra staff, the GPC said, forcing GPs to consider closing their list.

In a worked example, a practice with a Carr-Hill weighting of 0.8 whose list expanded from 5,000 in April 2004 to 7,000 by January 2006 would face a funding cut of £4.64 per patient.

The GPC guidance advised GPs to involve the LMC and even the local media if they did not get adequate extra funding.

GPs who agreed to take over a retiring singlehander's list should negotiate an extra payment for the lack of a 'list turnover index' ­ which covers the fact that newly registered patients consult more frequently, it said.

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