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Managers ask QOF winners to bail out losing practices

By Gareth Iacobucci

NHS managers are asking GPs who will gain under the scrapping of the square root formula to help bail out QOF losers by handing back part of their funding, Pulse can reveal.

The proposal – greeted with outrage by GPs approached with the request – comes as primary care organisations face growing pressure to step in to aid financially stricken practices.

Pulse's campaign to name and shame PCOs that refuse to help practices hit by changes to the QOF prevalence formula showed signs of progress this week, with GP leaders reporting some had come to the negotiating table.

But Middlesbrough and Redcar and Cleveland PCTs have drawn up plans for other GPs to come to the rescue.

A joint letter to LMC representatives from Colin McLeod, chief executive of both trusts, said his board ‘would be willing to support an arrangement where those practices gaining funding would provide financial support to those losing funding'.

He added: ‘The board considered this would be a discussion the LMC could facilitate with the PCT providing administrative support, as long as the overall payment in each PCT was not increased as a consequence of such an agreement.'

But Dr Julie-Anne Birch, a GP in Guisborough and member of Redcar and Cleveland LMC, said it was not the job of practices such as hers – which had suffered underfunding up to now – to bail out losing practices.

She said: ‘We've struggled for years being underfunded. Finally we're going to get a fairer payment for the work we do. I don't think we would be very happy if we saw that benefit immediately taken back off us.'

Dr Birch backed Pulse's campaign to support practices hardest hit by the changes, but said it was up to PCTs to assist them: ‘I don't want to see a practice go under because they immediately get a massive cut. I feel that's up to the PCT to sort out a short-term transition.'

GPC chair Dr Laurence Buckman claimed PCOs were beginning to cave in to pressure: ‘PCOs seem more mindful of the need to follow the spirit of our agreement with NHS Employers. Some that had seemed relucatant are now less reluctant.'

NHS Leeds said it had made progress in negotiations with its LMC and was drawing up a list of new services that QOF losers could offer under LESs.

But dozens of PCOs have still not entered talks with GPs, despite a request from the Government.

Of 80 responding to Pulse's request for details of support being offered, a third have yet to begin any talks with GPs.

Even those that have entered dialogue are displaying a hard-nosed lack of sympathy.

NHS Doncaster indicated the solution for three practices standing to lose out was for them to perform better in the QOF.

Dr Julie-Ann Birch: supports Pulse campaign but insists it's not up to QOF winners to give up their pay Dr Julie-Ann Birch: supports Pulse campaign but insists it's not up to QOF winners to give up their pay QOF list of shame

PCOs definitely not planning to support losers
• Heart of Birmingham PCT
• NHS South Gloucestershire

PCOs not yet in talks with GPs
• NHS Bury
• Calderdale PCT
• NHS Central Lancashire
• Croydon PCT
•NHS Cumbria
• Derbyshire County PCT
• NHS Ealing
• Dudley PCT
• NHS East Sussex Downs and Weald
• NHS Hastings and Rother
• NHS Havering
• NHS Heywood, Middleton and Rochdale
• Hillingdon PCT
• Newham PCT
• Northamptonshire Teaching PCT
• Rotherham PCT
• Sandwell PCT
• Solihull Care Trust
• Telford and Wrekin PCT
• NHS Walsall
• NHS Waltham Forest
• NHS Warwickshire
• NHS Lothian
• Bridgend LHB
• Swansea LHB

Source: responses to Pulse survey

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