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At the heart of general practice since 1960

Partners at ‘outstanding’ practice forced to quit as funding is cut by 30%

Four senior partners at a practice rated ‘outstanding’ by the CQC have been forced to quit after an NHS England PMS review saw funding for the surgery cut by £400,000.

NHS England have put a tender out for the Sutherland Lodge Surgery in Chelmsford after its four senior partners gave notice to NHS England earlier this month and will be leaving at the end of June.

The partners - Dr Ged Cunniffe, Dr Rob Climie, Dr Joanna Birn-Jeffery and Dr Hilary Ramsay - said that the cuts would see their patient ratio more than double and that they would ‘not be comfortable providing the significantly reduced level of service that the new contract would require.’

The practice, which has existed for 110 years and serves 12,200 patients, was informed by NHS England just before Christmas that it would have its budget cut by £380,000 over two years from April 2016 as the result of a PMS review.

This is despite the practice being told by the CQC on Monday this week that it was receiving a rating of 'outstanding’ following an inspection in October last year.

Its practice manager has warned that a closure would put greater pressure on already stretched local providers.

NHS England said its immediate priority was to secure a new provider to ensure patients have continued access to GP services from 1 July 2016.

This is the latest practice to be facing potential closure, a trend that has been highlighted by Pulse’s Stop Practice Closures campaign.

However, this practice is believed to be the first facing closure after receiving a rating of ‘outstanding’ by the CQC.

In a note on the practice website, the partners said: ‘This loss would mean a severe cut in the services we have worked so hard over the years to develop.

‘We feel very strongly that after the inevitable rise in the doctor to patient ratio, which will move from 1:1890 to 1:4000 we will not be able to continue to provide the current level of services.’

NHS England said in a statement that the decision to cut funding from Sutherland Lodge surgery would help make mid-Essex GP care ‘sustainable’ and that it had started a process to find a new service provider for Sutherland Lodge

‘NHS England carried out the review to make sure GP funding was equitable across all GP practices, and get the best results from investing in quality services for patients.

‘The review’s outcome was a reduction in funding for all of the six mid Essex practices that had PMS contracts, with the money to be reinvested in making all mid Essex GP care sustainable.’

Sutherland Lodge practice manager Carol Sams told Pulse that funds had been cut from the practice because it did not have enough high-cost patients.

She said: ‘NHS England was looking at whether a practice had a particular cohort of patients for basic care services like travellers, care home, non-English speakers – time intensive patients. They didn’t ask about the extra services we provide like mental health and dermatology.”

'If we go under our neighbouring practices, which are all overstretched anyway, will have people queuing out of the door,' Ms Sams added.

The practice said that it was ‘sad and ironic’ that it had recently received an ‘outstanding’ rating from the CQC.

NHS England said it was working with NHS Mid Essex CCG and the Essex LMC to identify a new provider. In the meantime, Sutherland Lodge Surgery will continue to provide services to patients. 

Which practices are eligible for NHS England support? 

Stop Practice Closures-logo-online-330

Stop Practice Closures-logo-online-330

 

NHS England announced in December that practices given poor CQC ratings or found to have higher-than-average referrals and prescribing ratings will be prioritised for a £10m support fund.

The beneficiaries of the ‘turnaround’ fund – pledged as part of health secretary Jeremy Hunt’s ‘new deal’ - will have to be identified by NHS England by 28 January 2016, NHS England director of commissioning Rosamond Roughton said.

Ironically for Sutherland Lodge Surgery, the prioritising of practices receiving poor ratings would count against them, and the practice received a rating of ‘outstanding’.

Readers' comments (61)

  • Carry on NHSE. Hearty congratulations on another success story !

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  • And so it continues!Thanks commissar.

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  • on one hand I find the idea of PMS fundamentally unfair, but on the other destabilising practices through sudden removal of income is pretty awful too.

    Im morally conflicted.

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  • By my calculation they have been getting £31 per patient more than surrounding practices. Labelled an outstanding practice by the CQC. That goes to show that putting more money into primary care leads to a better service. So why cut their funds? Why not put the same amount into all practices.

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  • I have enormous sympathy for the partners, but maybe they managed an outstanding rating because they were so much better funded than average? I am sure a lot of practices could do better with so much more money.

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  • It all goes to show, that if the funding is right services we can have outstanding practices, and that underfunding leads to the withdrawal of services.

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  • THERE IS STRONG EVIDENCE NOW THAT CQC OUTCOMES ARE LINKED TO AVERAGE GMS AND PMS FUNDING.
    IF YOU PAY A PRACTICE A MASSIVE AMOUNT EXTRA, ALMOST ANYBODY COULD PROVIDE AN OUTSTANDING SERVICE.
    OUR PRACTICE IS PAID PEANUTS IE LESS THAN £110/PATIENT IN AN AREA OF SIGNIFICANT DEPRIVATION SO THERE IS A HUGE CHALLENGE.
    SOME OF THESE OVERFUNDED PRACTICES SIMPLY CANNOT COPE WHEN THERE IS A LEVEL PLAYING FIELD.
    THE ANSWER IS NOT TO REDUCE THEIR FUNDING BUT TO INCREASE OURS TO A FAIR AND EQUITABLE AMOUNT.

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  • That's market forces.

    Not going to be easy for whoever takes over.

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  • John Glasspool

    Yup! I'm with 5.58. When this PMS thing first started, I asked a local colleague why he and his partners had done it. His reply? "Simple, £10k per partner more per year".
    There you have it.

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  • The idea that the reasons for the PMS funding reviews is to develop equity is complete nonsense. Firstly, all the premium money stays within the CCG area which means that if you are a PMS practice in an area with many other PMS practices you are better off, but if you are one of a handful of PMS practices, the premium pot much lower for recycling. True equity can only be reached if the PMS premiums for the entire country are amalgamated and recycled. Otherwise it becomes another postcode lottery.

    Secondly, patients are not equal. Sone don't speak English, some are high users of healthcare through culture or social care needs, some have immense public health issues. But none of this is taken into account when the recycling process starts because it is a dangerous of worms.

    I feel for this practice because if they were in an area with a majority of PMS practices, the pot would be larger.

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