GP cash-flow warning as LMCs report NHS England’s local area teams face ‘huge problems’

Exclusive GPs have been warned to make contingency plans to protect their cash-flow this month, as LMC leaders warned many of the local area teams that have assumed responsibility for GP contracts this week face ‘huge problems’ and a lack of capacity to carry out their job effectively.

LMC leaders warn that local area teams are not yet fully set-up and staffed, and as a result GPs may not be paid in time for them to manage their cash-flow effectively.

Pulse can also reveal that Dr Stephen Cartwright, the medical director of one of the biggest area teams, the West Midlands, left his post one week before the body was due to come into being.

Last week, the chair of NHS England, Professor Malcolm Grant, said that the teams were not fully formed and would ‘take a little while to be fully up and running’. But NHS England - formerly the NHS Commissioning Board - said that they were ‘confident’ the local area teams would be able to continue PCT functions seamlessly.

Dr Robert Morley, chair of Birmingham LMC, said he was concerned that the local area team was ‘lacking in capacity and experience’ and would be covering a huge area.

He told Pulse: ‘The scale of the area and job they have to do is enormous, whereas the number of people doing the work is much smaller – we are told there are eight people in the GP contracting team covering 600 practices.’

‘We have huge concerns over the finance functions which nationally have now been farmed out to NHS Shared Business Services and we have heard stories in the past about problems with practices getting paid properly, and now this is a national contract.’

‘We are worried about practices getting paid properly and at the right time. We have advised that practices put financial contingency plans in place in case they end up not being paid as they should.’

The resignation of Dr Cartwright was also a concern, he added:  ‘Clearly that director has a huge role in terms of revalidation and appraisals of over 2,000 GPs. The problems they are facing are huge.’

Those concerns were echoed by Dr John Hughes, chair of Manchester LMC. He said: ‘They have got senior people appointed, but a lot of them don’t appear to have teams in place.’

‘Some of the senior people have left posts, but and it is not clear whether they have been replaced.’

‘We have had no communication about who we contact in case things go wrong. We haven’t been told who the public health consultant is, who we contact if there is a major outbreak of infectious disease or an epidemic. It isn’t properly sorted and it won’t be properly sorted for six months.’

There were also specific worries about practices being paid, he added. ‘Some practices in Stockport normally receive LES payments monthly, but they have been told this is now quarterly, dumping practices with a significant cash flow problem and there was no discussion about that.’

Dr Peter Scott, chair of Solihull LMC, also said that there was a lack of information about the local area team in his patch.

He said: ‘We haven’t get any hard facts about who is in the local area team. I have been assured we will be paid but I cannot tell you by who and it will probably be by shared services. It all remains unclear.’

Dr John Ashcroft, deputy chair of Derbyshire LMC, said he was ‘surprised’ at how much was being rushed through at this stage.

He said: ‘A lot of the people have only been given the jobs in the last few weeks. I’m surprised about how late these things are being sorted.

‘Considering the number of reorganisations there has been, I would have thought the health service would have been better at it by now.’

But an NHS England spokesperson said they were confident that the local area teams would be able to cope.

He said: ‘There has been a significant amount of work on the part of clinicians and managers over the past 18 months preparing for next month’s changes and to ensure success. We are confident that the new organisations, including the NHS England and its area teams, will be ready to discharge their functions.

‘There is of course a lot to do before they are achieving their full potential. So next month is an important milestone on our journey, but it is not the final destination. We will all need to keep learning and listening as we go so we build an NHS that is more responsive, more transparent and more compassionate on behalf of patients.’