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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)

  • That's what happens if you don't have a GP in the Practice who is on the Board of the CCG

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  • Yes, we've lost £50k last year. That goes to funding our practice manager and salaried GP, core GP service not extras!
    The NHS is in a really bad place :(

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  • CCG should also warn surgeries when extra money is being paid to provide any new services by the GP surgeries - because it looks like some of our GP colleagues would go into extreme stress when they see extra income coming into the surgery.

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  • Dear All,
    A CCG is a membership organisation. Members, who are the GPs, should be able to have their say about the CCG Board memebers, who are GPs.
    Regards
    Paul C

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  • This is another reason why mass resignation is only option we GPs have to be listened to.

    Mass ditching of NHS contracts is how we will be heard!

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  • Dr Cundy has it spot on. The GPs in the CCG (which is a membership organisation) should get together with the appropriate majority in the constitution and hold the CCG to account. If the membership wishes, this could be reversed

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  • some CCG funded OOH provider like Care UK was not value for money , but some made a pile of money out of it . If a service does not provide a valuable result it needs to be scrapped.

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  • The £5 a head money is commissioning money, not part of GMS/ enhanced services. It needs to be evaluated like any other commissioning money. If the GP membership had commissioned another provider to provide a service and they hadn't delivered, I suspect they wouldn't think twice about decommissioning it. At the end of the day the CCG board has a statutory duty to balance it's books. If Pulse had any real journalists these facts would be in the article. This 'angle' of 'the world is against us poor GPs' helps no one.

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  • it's a cull of the weakest ... not necessarily of the worst practices or GPs but those that don't fit the 'new' paradigm.

    either you cosy up to the CCGs and follow the political directive or you will be culled.

    shame but the direction of travel is to eliminate all small practices in favor of large super practices providing more services at lower cost or the 'tesco' model. so no more local services.

    if you want out the only option is to exit a la dentists.

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  • Local LMC should hold CCG to account and surely board GPS should resign

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