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GPs buried under trusts' workload dump

Partners faced with £800,000 potential liability following practice closure

GP partners at a practice that is set to close face personal ‘financial ruin’ from a bill of £800,000, having taken out a long lease with the support of NHS managers.

The North Bicester Surgery in Oxfordshire is set to close for good on 30 September because the withdrawal of MPIG funding has made it ‘financially unviable’, leaving 4,500 patients having to find new practices. 

As a result of the closure, the senior partner has told Pulse he could face being hit with almost £1 million in bills because there are eight years left on the lease.

However, he added that he took on the 25-year lease in 2000 following enthusiastic support from the health authorities, because Bicester is and was one of the fastest growing towns in Europe.

The BMA has warned of the risks of GP partners, with GPs facing the danger of being left with all the practice’s liabilities were they to be the last partner to leave.

Senior partner Dr Andrew Gibson told Pulse that his practice was on the NHS England list of 99 practices deemed as being at risk due to MPIG cuts - yet no support was forthcoming and now the practice may have to close.

But, as a result of the proposed closure, he may be facing ‘financial ruin’.

Dr Gibson said: ‘The nasty underside of this is that we are left with a building and a lease that runs for another eight years and obviously the landowners – the freeholders – will want their lease paid.’

The premises are owned by a private landlord, and Dr Gibson’s name is the only one on the lease.

He added that the purpose built premises was designed with encouragement from NHS managers.

Dr Gibson said: ‘We built it in 2000 with the NHS provision in mind, growing Bicester, safe as houses, 25-year lease. When it came to having a purpose built premises it was the obvious thing to do – I wanted to do it and they wanted me to do it, so it was a mutual encouragement, if you like – it made sense.’

However, he added: ’If [the landlords] call in the lease I’ll be facing a bill of £800,000.’

GP leaders said that GPs must be alert to the dangers of being the last man standing. Dr Peter Holden, member of the GPC finance subcommittee and former GPC premises lead negotiator, said the case was an ‘object lesson’ for GPs to ensure they take specialist advice before taking on a lease.

Dr Holden said: ‘I feel very sorry for this GPs but this needs to be an object lesson. The bottom line is, he who signed the lease is responsible for it and GPs need to be warned that if there is no break clause the landlord wants your money every quarter until the end of that lease. Your estate is liable.’

He added: ‘The problem is that the GPs are in the middle of this process. Some anonymous civil servant or minister will come in and change things, but there is no impact to them – the impact is taken at the North Bicester level.’

Julie Dandridge, head of primary care and localities at Oxfordshire CCG, said: ‘We are currently working closely with North Bicester Surgery to help them support all of their patients during this time.

‘We understand that some patients may be worried about these changes but we are positive that they will continue to receive good treatment from one of the four other GP practices in the Bicester area or wherever they choose to register.’

Debra Elliott, director of commissioning at NHS England South Central, said: ‘NHS England will continue to work with Oxfordshire CCG and North Bicester Surgery to ensure the smooth transfer of patient care and records and those patients with more complex conditions are supported as they look to move to alternative GP practices.’

Pulse campaigning for support for vulnerable practices

Stop Practice Closures-logo-online-330

Stop Practice Closures-logo-online-330

Pulse has been pressing for immediate support for vulnerable practices across the UK since 2014 through its Stop Practice Closures campaign, and NHS England has recently announced a new tranche of £16 million of funding to support struggling practices.

Health secretary Jeremy Hunt first announced the fund in his ‘new deal’ last year, and NHS England said in December that practices with poor CQC ratings or higher-than-average referrals and prescribing would be prioritised.

By March 2016, NHS England had formally identified more than 800 GP practices as vulnerable as part of its work to allocate £10m worth of support funding.

It found the situation was worst in the North Midlands where 22% of practices were identified as struggling. In London and South Central, around a sixth of practices have been identified as eligible for support funds.

 

 

Readers' comments (34)

  • I have the greatest sympathy for Dr Gibson who is facing a potential £800,000 bill. This is the fate of unlucky GPs, bankruptcy or death or imprisonment.. A salaried contract is a better option in times of distress.. The BMA should be trying for a massive change in our contracts to protect GPs from such occurrences.
    The alternative for Dr. Gibson was to keptrunning the practice somehow eg by becoming singlehanded and using locums and nurse help , for the next 8 years. My friend who works here is doing just that.
    Dr. Gibson, contact me for a solution. My email is mukherjee1@sky.com I am confident it can be rectified.
    Retired GP

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  • @10:41 NHS Manager

    How much Primary Care premises do you manage? I hope none i really do. Having moved from a CCG where i did do some of the Premises management it is shocking how little knowledge 'NHS Managers' have of the situation.

    The cost of premises to the NHS varies wildly both geographically and due to building condition. Your idea of just rolling it into the global sum is one that is looked at regularly but what value are you going to give it? Old old victorian converted house in the north of England might be costing £4 per patient in rent, whereas a new healthcentre in London might be close to 10 times that.

    What has come out quite clearly in both the story and responses is that the NHS centrally will help to look after the patients but has little to no regard for those providing the care. Evidence supports the case that the independent contractor model is the most cost effective one. If 'managers' destroy it the whole country will pay the price.

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  • Have any of the 'vulnerable practices' actually seen cash from the £16 million pot which has been set aside for those about to fall over, or has it come too late to benefit them - as usual?

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  • So the GPC rep blames the GP for being silly and signing the lease, how long will it take before GPs realise that the GPC have negotiated us into this ridiculous position where we are personally liable for the failings of a system that is way beyond our individual control. The future cannot be self employment under a GMS or PMS contract with hard working honest individuals liable for the consequences of policy changes. feel very sorry for the GP;s involved, there but for good fortune go us all...

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