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Practice 'loses £55,000' as CCG cuts £1m enhanced service without warning

A CCG has cut more than £1m in practice funding after decommissioning an enhanced service designed to improve care for vulnerable patients, without consulting the LMC. 

Walsall LMC said that practices had employed staff as a result of the enhanced service run by NHS Walsall CCG, which involved elderly patients receiving extra health checks, care plans and medication reviews and had 100% sign up from local practices.

But the CCG has pulled the £1.13m funding - which was worth £55,000 for one practice - leaving practices having to make staff redundant.

The CCG said that this was because the scheme was 'not able to demonstrate value for money'.

However, the LMC said that it was primarily decommissioned because the CCG has a £20m budget gap.

The enhanced service was initially funded via the £5 per patient that CCGs were supposed to redirect from hospital budgets to support GP practices in reducing avoidable hospital admissions, as part of the Avoiding Unplanned Admissions DES.

Walsall LMC medical secretary Dr Uzma Ahmad told Pulse that under the LES specification half of the money was to be used to fund extra staff and that practices would therefore potentially have to make redundancies now the funding was gone, including 'at least one practice which is having to make a salaried GP redundant'.

Dr Ahmad said: ’Suddenly come April, the CCG announced that the service had been stopped without engagement with patients or providers, including GPs and LMCs.

’One of the practices lost £55,000 through the service because they are a big practice with lots of nursing homes. We might now have to make the staff redundant.’

She also said that although patients were ‘very angry’ about the loss of the service, ‘no one is listening’ to their complaints.

Dr Ahmad added: 'The service has been cut with no sensitivity at all. There is nothing left for patients who are now left in limbo. It is disproportionate and has come with no engagement with GP practices. We are a victim of our own success.’

NHS Walsall CCG said it had commissioned the local service in 2015 with the intention to 'reduce emergency admissions and A&E attendance', but that following an 'evaluation of the scheme' it was found not to deliver value.

A spokesperson said: 'An evaluation of the scheme was undertaken, and following careful consideration of the strengths and weaknesses of the scheme, and on the basis that the scheme was not able to demonstrate value for money, a decision was made to end the scheme.

'The CCG has also made significant investment into its frail elderly services through commissioning additional community services and is working with these services to support practices in mitigating any risks.

They added that the CCG 'remains committed to transforming primary care and will continue to work with GP practices and the LMC to ensure sustainability'.

Dr Ahmad said the CCG had not shared the evaluation results with the LMC but that even if it had not led to reduced admissions it did not mean it was not a useful service.

She said: 'They are not willing to share the data. They are hiding it from us.'

It comes as the GPC has agreed with NHS England to look into scrapping the Avoiding Unplanned Admissions DES from 2017 onwards.


Readers' comments (25)

  • local lmcs and ccgs have cosied up with nhse and have private meetings to discuss personal interests -corruption in nhs has come to a head. time to cull ccgs and liquidate lmcs and rcgp.we need a total boycott of membership of these organisations

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  • I think practices should be ensuring these vulnerable patients now specifically do not get any better service than the rest of the patients.

    Encourage them to attend A&e if there are no appointments left and once those numbers start increasing they may think about the real cost of pulling this service.

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  • If you feel that the CCG is not prepared to share data, attend the next governing body meeting (it is a public meeting) and raise the issue.

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  • This is the price you literally pay for short term contracts. At to be fair its what happens in every other commercial market.

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  • For me this does bring into question how effectively these GPs are managing their businesses. For a short term contract, surely you would have fixed term employees so no redundancy issue?

    And surely you would make sure an appropriate notice period was included in the agreement so you have time to adjust to any changes?

    Or were people driven to grab the small amounts of money dripping out of the system but forgot the basics in the rush?

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  • Well said Anonymous | GP Partner 01 Jun 2016 7:36pm

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  • reduced general practice funding = Reduced GP clinical session time = increase secondary care pressure.

    increased GP funding = more GP clinical session time = reduced secondary care funding.

    - anonymous salaried!

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  • it is not about corruption / backhanders etc. it is none of my business what is on my neighbor's plate, but my calculations are incredibly simple. Workload is defined by level of funding. anything beyond goes to A&E.

    have a look at this if you want to make your eyes water!

    - anonymous salaried!

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  • Same problem in Lincolnshire East. This year's £5 monies used to fund an Older Adults Service, but participating practices told that reimbursement won't exceed 2015-16 funding - we can't access the balance of our unspent £5ph. So the spec asks us to do far more for the same money. PMs have been told the remaining money doesn't exist. Feels like the CCG wants us all to throw in the towel and leave the money to pay off an overspend somewhere else in the system.

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  • 2.04pm you will be paying for the massive hole in United Lincolnshire Hosptials Trusts finances.

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