Exclusive Just 15 practices out of the 98 identified by NHS bosses as being at imminent threat of closure due to MPIG funding cuts are eligible for the delay to funding cuts to help them stay open, a situation that has ‘made a mockery’ of NHS England’s support package, the GPC has said.
Negotiators said that they had ‘learned from practices involved’ that only a small handful of practices were eligible. This followed meetings between NHS England’s head of primary care commissioning Dr David Geddes and at-risk practices, Pulse understands.
The GPC said that the small handful of practices who stand to gain ‘made a mockery’ of NHS England’s offer of relief funding to practices, and that the criteria used for determining eligible practices – including a greater than £3 loss per registered patient – had been ‘plucked out of thin air’.
Campaigners from the Save our Surgeries campaign – which, led by the Jubilee Street Practice, had led the push for increased funding – told Pulse the offer was ‘wholly inadequate’ and that hundreds of practices even outside the 98 most affected by MPIG withdrawal were facing imminent closure if no action is taken.
They added that the Jubilee Street Practice – which is the only one to publicly accept the offer as yet – had been ‘forced’ into acceptance, as it was ‘only weeks away’ from closure.
The Government announced as part of the 2013/14 contract imposition that it was phasing out funding the minimum price income guarantee (MPIG), but it became apparent that the withdrawal of this funding would hit many practices in deprived areas.
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How are MPIG cuts affecting practices?
NHS England subsequently identified 100 practices – later reduced to 98 – which were at most risk of closure through the withdrawal of MPIG. But it was only after campaigning by Save Our Surgeries that it made an offer to practices in London – which it said would be rolled out across the country – to delay the withdrawal for two years.
To be eligible for support, practices had to fulfil a number of criteria, including:
- a reduction in GMS global sum funding greater than £3 per weighted patient in 2014/15;
- no doctor in the practice declaring pensionable earnings in excess of £106,100 per annum, with a pro rata adjustment for part-time GPs (the England average for 2011/12);
- practice expenses evidenced as greater than 63%;
- no contract breaches for any reason issued since 1 April 2013;
- fewer than half of contract holders having ‘live’ cases with NHS England performer machinery or GMC, including the Interim Orders Panel
- fewer than five outliers on the GP High Level Indicators (GPHLIs) on the current system;
- evidenced extenuating circumstances within the practice population related to patient demographics that impact on practice workload – defined as an IMD score of 35 or higher for the practice population.
But GPC deputy chair Dr Richard Vautrey told Pulse that NHS England had simply tried to appease the most vocal campaigners, making the offer as restrictive as possible to prevent too many other practices applying for help.
Dr Vautrey said: ‘We’ve learned from practices involved that only 15 are eligible for the funding. I think NHS England were under political pressure to find a solution for deprived practices in London and set criteria plucked out of thin air, to make it as limiting as possible, to limit their financial liability and the number of practices that could request similar funding.
‘A conspiracy theorist might suggest that the criteria that were laid down were so rigid there would only be one practice able to be successful – and that sort of makes a mockery of the whole process.’
Dr Ron Singer from Save our Surgeries campaign, said: ‘The Jubilee Street practice, which launched the Save Our Surgeries campaign, has been forced to accept NHS England’s inadequate offer – otherwise it was weeks away from having to close. But nothing changes as far as the campaign is concerned.
‘We’re now extending it beyond the MPIG 98 – because we know there are hundreds of practices, losing slightly less per patient, that are also in real trouble.’
A source close to affected practices said that the information had come from Dr Geddes.
The source said: ’ David Geddes mentioned there were 15 [eligible practices]… But any other practice that doesn’t fit that, they have to go and find their own solution.’
Pulse had revealed that Cambridgeshire LMC had already contacted NHS England to review the offer, because it was too restrictive.
Pulse launched the Stop Practice Closures campaign as a result of the impact that funding cuts and recruitment problems were having on practices.
NHS England has been approached for comment.
