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Triple whammy forces 17,000-patient practice to hand back contract

An inner-city GP practice with over 17,000 patients has handed back its contract because it can no longer offer a 'fair and adequate' service to patients.

Charlotte Keel Medical Practice, which operates in a deprived area of Bristol, said its core funding had been eroded by a five-year review of funding linked to its PMS contract.

NHS England and CCGs have been redistributing PMS funding since embarking on a review in 2013, when it identified £260m worth of funding that it said was not directly linked to additional patient services, although GP leaders warned it would destabilise practices.

The Charlotte Keel Medical Practice said it had applied for funding for 'atypical' practices to fill the gap, but had received no response from the CCG or NHS England regional team.

In line with guidance issued earlier this year, practices with large numbers of patients who do not speak English should be able to access additional funding. The practice said that because of its location in a deprived area it also has a large proportion of patients with significant mental and physical health problems.

In addition, the practice said its funding is being hit by scrapped subsidies on the rental costs of the NHS-owned premises it occupies.

It told patients in an announcement on its website: 'On the basis of these funding changes, the partners have been forced to conclude that, from 1 April 2018, we would not be able to deliver a fair and adequate service to our patients, who already face significant health inequalities.

'In giving notice now, before the full force of the funding cuts take effect, we trust that we are acting in the best interests of the patients and staff of the practice in allowing another organisation, with likely access to additional resources and funding streams, to take over the management of a fully functioning practice.'

The GP partners added in the notice that they hoped their 'very difficult decision' would 'cause NHS England and Bristol CCG to reflect on the need for an appropriate level of funding to be provided to meet the needs of our patient population in inner-city Bristol'.

The practice contract has now been put out to tender by NHS England as a two-year, time-limited APMS contract, with BrisDoc Healthcare Services Limited identified as the preferred bidder.

NHS England South West commissioning director Debra Elliott said: ‘A minority of practices such as Charlotte Keel that received more funding in the past are unfortunately having this [funding] redistributed – but most across the city are receiving more.’

She added that NHS England and NHS Bristol CCG have worked with the practice but the 'partners felt unable to accept the support and investment we had offered to help them build a more sustainable business model, so we are now seeking to appoint an interim provider to make sure patients continue to get access to good GP care'.

Charlotte Keel Medical Practice is one of two Bristol-based practices to recently hand back its contract, with the CCG announcing that the Bishopston Medical Practice has also been put out to procurement with BrisDoc as the preferred bidder.

It is expected that BrisDoc will run the Charlotte Keel Medical Practice, which has 17,200 patients, from April and the Bishopston Medical Practice, which has 10,400 patients, from February.

NHS Bristol CCG and NHS England said that they would look for a 'long-term solution' for the practices which is based on 'greater economies of scale'.

CCG chair Dr Martin Jones said:‘The long-term solution goes hand in hand with the work we are doing across Bristol, North Somerset and South Gloucestershire to increase sustainability of primary care by supporting GP practices to work closer together.’


Readers' comments (10)

  • Sounds like a stitch up or power grab by the local great and good.

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  • Sad, but there are plenty of practices in inner-cities and other deprived areas offering excellent services without the benefits of exceedingly generous PMS funding. Clearly, there should ideally be a process of balancing up, where every practice benefits from such enhanced funding. Unfortunately, this downwards redistribution must be very painful for the affected partners.

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  • David Banner

    Hunt's policy of slowly suffocating GP partnerships and replacing them with APMS private providers without the public noticing marches on apace. The only grim satisfaction will be when he realises this will in fact cost a fortune and the APMS brigade will desert when profits vanish.

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  • The funny thing is that mainly PMS Practices are falling not single handed underfunded GP Practices who have become used to managing with underfunding and surviving on scanty budgets. PMS and APMS were favoured and given up to 250 pounds by NHSE Managers with 'large hearts'. Now when the crunch comes in, they are falling like dominos even though their per patient income is significantly more than that of an ordinary GMS. Well, this day had to come and although one feels sorry for the colleagues and patients involved - deep down, we've always known you can't be favoured forever on a temporary contract.

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  • AlanAlmond

    With the greatest of respect to BrisDoc I can’t see that having your care taken over by an out of hours provider will be anything other than very bad news for the 17,000 people registered at this practice.
    It’ll be a walk in nurse lead service with Locum Dr support, and if the future is a 2 year rolling contract that will be the long term for this place. It reflects very badly indeed on the CCG that they couldn’t find an alternative way forward to what is basically a ‘slash a burn’ approach to a failing practice. Is this actually what anybody wants? I dont think so. I can’t see it’s what the leaders of the CCG wanted either. Very poor - all round.

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  • Vinci Ho

    ‘’The practice contract has now been put out to tender by NHS England as a two-year, time-limited APMS contract,’’

    So predictable of NHSE,
    So perverse.

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  • @ Last Man Standing- £114 per patient??? Whereabouts are you.
    We have to manage at £85 per patient in Medway - or maybe it's because 80% of us in Medway are BMEs ???

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  • pulse may like to do an FOI to see what rate is being paid for the APMS contract. it will be higher than before, then ask the question as to why the same deal couldn't have been offered to the incumbent partners.

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