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Mixed news for small practices


Small GP practices with fewer than 2,500 patients will be

eligible for extra money under the proposed revisions – but only if there is no other practice nearby.

The new cost of unavoidable smallness adjustment will ensure small practices only benefit if they have no opportunity to merge or work with their neighbours.

The review group aimed to 'establish a criterion for unavoidably small practices based on the trade-off between the opportunity for practices to benefit from economies of scale and patient travel costs, under a hypothetical merger of nearby practices'.

The Small Practices Association welcomed the adjustment in principle, but was concerned practices near to each other would not be eligible. Dr Michael Taylor, chair of the SPA and a GP in Heywood, Lancashire, said: 'I'd like to see assurances pressure will not be put on practices to merge.

'It is the word unavoidable that concerns me. Many patients want a practice to be small and this system doesn't seem to take account of that.'

Dr David Roberts, a non-principal GP in Northamptonshire, said he doubted the proposed changes would work.

'It depends on what you define as 'nearby'. There can't be close collaboration between two practices two miles apart.'

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