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GPs go forth

Vulnerable GP practices no longer have to match bailout cash from NHS England

Exclusive NHS England bosses have relaxed the requirements for vulnerable GP practices wanting to access emergency support, after reports that practices were being put off for asking for help from the scheme.

The £10m vulnerable practices scheme was announced in December last year, but required that GP practices matched the cash that was given to them from NHS England. But Pulse has learnt that NHS England has now removed this criterion as long as practices could report how the cash will be used 'in kind'.

The news comes as LMC leaders around England have hit out at the time it is taking for vulnerable practice support to reach practices that are on the brink of closure.

A further £40m of resilience funding was promised in the GP Forward View in April and details of how the £16m pledged for rollout this year can be accessed is expected imminently.

To date, NHS England has sent out a prior information notice about a competitive tender for GPs and wider primary care organisations to provide support, including mentoring and help with IT and practice management.

A spokesperson for NHS England told Pulse that the requirement to match funding from the scheme had been waived for practices.

He said that this had been mentioned in the GP Forward View document published in April, although not widely publicised.

The paragraph says: 'In order to maximise the impact of this support (£10m), from April 2016, NHS England will offer support to eligible practices that are willing to match fund this additional support, or offer the equivalent resources commitment "in kind".'

The NHS England spokesperson said that commitment in kind 'basically means they just have to state the number of days of GP and practice time available and that this is proportionate to the support on offer and achievable for the practice to provide’.

GPC deputy chair Dr Richard Vautrey said that the shift away from matched funding came as a result of pressure from GPC 'as it was clearly a barrier to practices in difficult situations accessing appropriate funding and support'.

But he added: 'We remain concerned that the commitments made nationally have yet to be turned in to practical delivery in many local areas, and local CCGs and NHS England need to do more to use this resource as quickly and effectively as possible, as the need is certainly there.'

LMC leaders told Pulse that they were disappointed at the lack of progress in supporting vulnerable practices so far.

Dr Tony Grewal, a medical director at Londonwide LMCs, said: 'No money has reached practices - or even CCGs - as far as I am aware, on the back of the Forward View undertakings.’

Dr Zoe Norris, a GP in Hull and a representative for Hull and East Yorkshire LMC, said: 'We haven’t seen a sniff of the funding in Humberside as far as I am aware. I don’t know anywhere that has but plenty who applied for it are in dire straits.'

Manchester LMC chief executive Dr Tracey Vell told Pulse: 'Last year’s vulnerable practices scheme did not generate much interest due mainly to the part-funding basis for practices already at risk.'

Responding to the claims the funding is delayed, an NHS England spokesperson said: ‘I’m not sure what you mean by delays. This [resilience] scheme was only announced in April, as part of the GP Forward View, and is a five-year project. The £10m Vulnerable Practice Programme was set up as a year-long investment in December 2015, is currently ongoing and has five months to go.’

RCGP chair Dr Maureen Baker, told Pulse: ‘Our focus now is to ensure that the 108 pledges made in the Forward View are implemented effectively and as a matter of urgency, in the best interests of both general practice and patient care. We are expecting to hear updates on a number of other short-term commitments, including the development of resilience teams to help practices that are struggling, in the near future.’

What does the GP Forward View pledge?

'In 2015, NHS England committed to invest £10 million to support vulnerable practices. Eligible criteria for accessing this additional support was developed with NHS Clinical Commissioners and other national stakeholders, with around 800 practices identified as meeting the criteria.

This support is designed to build resilience in primary care and to support delivery of new models of care. RCGP support  for inadequate rated practices will continue as part of this programme. A multi-supplier (call off) framework will be  available to commissioners from September 2016 to support the programme.

This is likely to include a range of local and national providers and may be expanded over time. In order to maximise the impact of this support, from April 2016, NHS England will offer support to eligible practices that are willing to match fund this additional support, or offer the equivalent resources commitment ‘in kind’.

In addition, a further £40 million will now be committed to develop a practice resilience programme, starting with a £16 million boost in 2016/17. We will work with the RCGP and the BMA to develop this programme as quickly as possible, and consider introducing practice resilience teams.'

Source: NHS England's General Practice Forward View, April 2016


Readers' comments (8)

  • Peter Swinyard

    Oh good. But WHAT MONEY? WHEN? It's all very well the RCGP saying that they are supporting the GP Forward View etc but this is a crisis for real practices RIGHT NOW. My practice is still waiting. Some cannot wait and will close, and if I hadn't drawn my pension last year, which gives me an income, I couldn't have kept going. Get real. Get going. Get cash to practices which are starved of resources. Get it NOW. Or there will be no one left to enjoy the GP Forward View money in 2020.

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  • As a practice who has been earmarked as "Vulnerable" we have been waiting over 6 months for any type of assistance, not just financial. I have now received the Vulnerable Practice Scheme help pack - This contains a 34 page in depth Health Check tool that practices need to work through, Workforce Planner, 360o survey of the practice & Action Plan to complete. GPs, Practice Manager & all practice staff are required to engage 7 attend. 12 months ago this would have been an extremely useful exercise and I would urge any practice to embark on this NOW if you are beginning to struggle. However for my practice (10k patients) who are in real crisis we simply do not have the time or the resources to work through this. Our first meeting with NHS England Support is not until September with the 2nd in October. Any assistance, financial or administrative will not arrive before Christmas by which time it will simply be too late.

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  • Our smallish practice has been suffering for last two years. I have had a long illness preventing me to work, my partner is totally exhausted, locum fees have exhausted all our income to the extend that we take home most months no pay, working hrs each day. Being partners we take all the responsibility. We had to pay a large sum from our own bank account ( (22 K ) towards the improvement of our premesis as CQC requirement. Number of bigger practices have refused to comply with these improvements but we are made to do it. When and where this money is to help us especially smaller practices.

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  • You are right Peter
    In Dorset we have practices in the west , east and by the beautiful sea in Poole ...all in grand premises favoured by deanery placing 3 registrars in large practices. 1 tutorial for 3 so forget the old 1 to1 mentor model.
    These practices have the appearance of modern 5 star hotels.
    If you know medical history in primary care and start with dr Finlay ,then the modern health centres at huge costs ,then fund holding where £500k was not a surprise for big practice development ,you will see your small practice is like the cafe that serves the best breakfast and gets best reviews for personal care ,contrasting with motorway services.
    It is not about missionary or socialist values but one of business.
    Look at the patient reviews on NHS choices ..not my favourite

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  • Vulnerable, deprived and eligible for funding means the Practice has at least one CCG or LMC member or a past protege of the establishment. If you don't have any such entity, you are a rich Practice and can suffocate in your own vomit because NHSE and CCG will not acknowledge or recognize your dilemma. Guys and gals, you are dealing with people who do not care what happens to the NHS - staff or patients. They are there to fill their pockets and implement the privatization agenda. It's like those vultures in Acquisitions and Merger - they uy a firm, shred it and sell it off in pieces or they liquidate it to have no competition.

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  • Peter

    May I ask why do you carry on?

    Are there financial penalties for walking away or is it ( as is for most GP's) the loss of pride after so many years of hard work?

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  • Peter Swinyard

    ~Jo Smit - I ask myself the same question. But when you are last man standing with a large mortgage on the building, all you can do is plug on and make the practice as financially secure as possible so that when time comes to merge or be acquired, you do so from a position of strength and not weakness.

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  • This is another publicity coup by Mrssrs Hunt & Stevens.
    Call some practices VULNERABLE and you hit two birds.
    One, "We are protecting the patients of underperforming practices by giving them some small change."
    Two, by implication, "The vast majority of the practices are secure and protected, if not formidable."
    "We have yet again guarded the NHS, the envy of the world."

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