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The waiting game

Is your practice 'vulnerable'?

Find out if you meet the criteria

NHS England has detailed a series of factors that together signify whether practices are ‘vulnerable’, and should therefore be prioritised for funding from their local area team. 

They include:

  • A CQC rating of ‘inadequate’ or ‘requires improvement’
  • Individual professional performance issues
  • A high number of patients per whole-time-equivalent GP
  • A high percentage of GP sessions not routinely filled
  • Low QOF achievement – specifically those practices with a score of less than 85%
  • High referral or prescribing rates – where a practice is in the upper quartile for aggregate prescribing performance or referrals when compared with the average across the CCG
  • A recent application for a list closure
  • Low GP Patient Survey scores for: ‘Would you recommend your practice to someone who has moved in to the local area?’
  • Low GP Patient Survey scores for ease of getting through to the practice by telephone
  • Issues with practice leadership (such as partner relationships) – the guidance admits this is ‘hard to define’ so commissioners will need to justify any risk rating
  • Significant practice changes – ‘splitting’ is of more concern than ‘merging’ as the latter may be for positive reasons’ and may make practices more ‘resilient’
  • Significant concerns from LMC, CCG or NHS England

Source: NHS England letter to area teams, 7 December 2015

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Readers' comments (4)

  • We are none of these and we are extremely vulnerable.

    Go figure.

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  • Likewise - we don't fit any of the above but still feel very vulnerable and high stress levels among GPs (and me !!)

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  • Crude measurements and criteria to decide vulnerability. Decision made by people who have little understanding of the way Primary care works or is funded. Every practice is one retirement/sickness away from becoming vulnerable. The business model is not fit for 21 century General Practice.

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  • Some additional criteria - any one of which will tip the practice into the vulnerable category.
    Any single partner who has an ounce of dignity left
    Any single partner who wonders why his or her dentist is so much richer and happier
    Any single partner who realises that Joe Public is not his/her friend an only wants what he can take

    Any single partner who resents the fact that freelance doctors earn at least twice as much by the hour
    Any partner who realises that the survival of the NHS is a matter for the nation and not just a handful of people working within it.
    Any partner who has the sense to realise it is time to ditch the contract.
    Further suggestions welcome…….

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