Dr Alan Speers: ‘We are pretty screwed’
Dr Alan Speers on why he is considering all options as he faces a cut in his funding of 25% over the next seven years, due to the withdrawal of MPIG.
We are looking at a 25% reduction in our practice income, so we are pretty screwed basically. We thought we were going to be given some funding going forward and we have been told there is no funding.
We have a two-site practice, which is a village practice and also we look after the University of Essex, which makes us a slightly unusual GP practice and that is why we have had high MPIG payments for the past ten years.
We have 12,500 patients on our list, but because of our university practice we are weighted to 8,900. But 40% of our students are overseas students so we have a high demand and basically effectively run two main surgeries, and if this reduction in funding comes in we are going to have to wind down our university surgery, potentially.
We register 2,500 new patients a year, we do that over a week, and potentially from this year we are going to have to stop taking on new patients.
Pulse ran an article last week about how in Essex there is a recruitment crisis. This means there is not enough capacity in other surgeries to take on these patients. We have partners locally who are trying to resign and hand over their surgeries and they are not able to do so. It seems very short-sighted by NHS England.
We have spoken with the CCG in the past about commissioning extra services and they haven’t been interested so we are feeling we have to escalate this to whoever will listen, because it is a shocking level of service that our students will get, and they are potentially vulnerable people.
What we will potentially have to do is go down to part-time opening. We are open five days a week currently, from nine until five. We will probably go down to half-day opening. We are low users of the walk-in centre locally and we have very low A&E attendance rates, but I suspect both of them will go up because access will become an issue. We run a triage system for patients and we have booked GP appointments – all of that will have to be scaled back as a result of the loss of the funding.
We also have to look at the future job security of our employees.
I think NHS England is giving a mixed message. The guys who sent out the letter in December were saying that there were funds for these 98 outlier practices to help protect them against this potentially significant money loss. Yet the actual word on the ground is that there is no money.
We were thinking that OK, we are probably going to lose some money, but common sense will prevail and no one can survive with a 25% loss in their funding. But actually they seem quite happy for us to potentially fail.’
The impact that it will have on our student population is that they are going to have to go elsewhere. NHS England is being very short-sighted in terms of the use of A&E, where they are meant to help reduce pressure. It just hasn’t been thought through. We are cheap compared to an A&E visit.
The LMC is on our side. Dr Brian Balmer, the local representative is a member of the GPC and he is going to them about this. We are also getting our MP involved as well.
And obviously we have informed the university that if something doesn’t get sorted in the next two months then we are going to have to make these changes fairly imminently.
Dr Alan Speers is a GP at the Rowhedge and University of Essex Medical Practice in Colchester