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Plan to cut millions from core GP funds

The Government is intending to use the planned overhaul of the global sum formula to claw back millions of pounds from general practice, Pulse can reveal.

Winners under the reshaped formula face seeing their gains taken away from them through cuts to the money they get under MPIG.

The revelation makes a nonsense of Government claims that the review is intended to redistribute funds more fairly.

The scale of the clawback is unclear. But up to £46.5m would be taken out of core GMS funding if the gains of all winning practices under the global sum review were swallowed up.

The proposals to revise the global sum formula, currently out to consultation, were already fiercely controversial.

Under the plans, half of practices, principally those in small towns and suburbs, would lose as much as 19 per cent of their global sum income.

The other half were supposed to be winners.But Philip Grant, chair of the review group and a negotiator with NHS Employers, warned practices set to gain through the review could see their MPIG correction factors cut.

By contrast, practices that lost out under a revised formula would receive no new MPIG money.He told Pulse: 'If the global sum of a practice increases, either through an annual uplift to the global sum or from redistribution based on a new formula, its correction factor payment could be reduced.'

He said the aim was to phase out MPIG by reducing correction factor payments as agreed with the GPC in negotiations over the 2006/7 GMS contract.'

This agreed principle could equally apply whether an increase in global sum came from an annual uplift or a redistribution based on a new formula,' said Mr Grant.

Dr Laurence Buckman, deputy chair of the GPC, reacted angrily to the proposals. 'Never on any occasion has that been mentioned,' he said. 'It's designed to threaten GPs. I suggest GPs ignore what the employers organisation is saying.'

Dr Buckman said the GPC's position remained that correction factors could be phased out only through uplifts to the global sum.But in a second blow to GPs, the Department of Health suggested the GPC needed to make substantial concessions just to keep the current MPIG, which props up 94 per cent of practices.

A high-level source within the department told Pulse the MPIG was 'the most sensitive part of the negotiations' between NHS Employers and the GPC, and that there would have to be 'a trade-off between MPIG and the quality and outcomes framework'.

The source said: 'If the GPC insists on keeping MPIG they will have to give up something serious on the QOF.'

Last week Pulse revealed NHS Employers wanted to cut 120 points from the QOF or toughen targets in the pay deal rejected by the GPC.Dr Daniel Moore, a GP in Faversham, Kent, said his practice would be forced to cut unprofitable services such as cervical screening if it lost money through the global sum review.'It looks like the review would make the practice unviable,' he said.

• Comment, back page

How the review will bite

• Government plans to use review of global sum formula to strip millions from practices

• Half of practices were supposed to gain under the review, by up to 31 per cent, but these will have their MPIGs corrected downwards

• Half of practices will lose under the review – and these will be afforded no extra MPIG protection

'Patients will suffer most'

Dr Adam Pringle says patients will feel the pinch if global sum payments are cut.

Dr Pringle, a GP in Telford, expects to be a loser under the review. But he insists that rather than seeing pay fall further, GPs would try to reduce costs by offering shorter opening hours and cutting staff.'Access will get worse – there's no other way. It will be silly things such as blood tests, but if it costs more than we earn, patients will have to traipse to the hospital.'

Dr Laurence Buckman, deputy chair, GPC buckman

'It's designed to threaten GPs. I suggest GPs ignore what the employers organisation is saying.'

Department of Health source deep throat

If the GPC insists on keeping MPIG they will have to give up something serious on the QOF.

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