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GP partners working for free as GPC warns practices face 'financial meltdown'

Exclusive GP partners in some areas are in such financial difficulty that they have been unable to pay themselves for several months as the GPC warns that managers must act to avert a ‘serious crisis’ in general practice.

Pulse has learnt that LMCs are warning they have heard of several examples of GP partners not being able to take out drawings for months because of payment problems and swings in practice income, warning that the situation is unlikely to improve ‘anytime soon’.

The GPC warned they are hearing of increasing examples of practices ‘facing financial meltdown’ and has started an information-gathering exercise on the possibility of practices having to close.

The news comes as practices prepare for further disruption to their finances, with MPIG payments slashed, the review of all ‘premium’ funding going to PMS practices and local enhanced services being put out for competition.

GPC member for Manchester, Salford, Trafford and Stockport, Dr John Hughes, said there was a ‘potentially very serious situation’ developing where multiple practices could become financially unviable.

Dr Hughes said: ‘We’re getting a lot of information about practices where partners haven’t made any drawings for two to three months. Somehow they’ve had to put money into the practice to be able to pay the practice staff.’

He added: ‘It is for multiple reasons - delayed payments due to chaos of outsourced and multisource payments where previously done by the PCT finance department, changes in timing of payments, changes in some areas which previously had advance of QOF predicted payment, loss of LESs and many other factors.

‘And all this is before MPIG or PMS changes come in, with many practices struggling with income and little prospect of improvement in near future.’

Dr Hughes said the GPC was investigating the possibility of practices closing: ‘GPC is collecting and collating info from all LMCs as this seems to be an England-wide problem, and could potentially result in practices becoming financially unviable and having to close, with all the implications that carries.’

Dr Chris Hewitt, medical executive director at Leicester, Leicestershire and Rutland LMC, said he was planning a local ‘crisis’ meeting to discuss how to advise practices at risk.

He said: ‘They can’t pay their bills, they are having to put in money, they are overdrawing [from the bank] and having to let staff go. I have been calling for a crisis meeting with the LMC, CCG and area team. Normally I’d say don’t overreact and take a portion of your drawings, however I think this is genuine, some people are really struggling at the minute.’

GPC negotiator Dr Beth McCarron-Nash said: ‘What we are hearing from several LMCs, across several areas, is of varying degrees of financial hardship and anecdotal stories from some areas where partners have actually not been able to take drawings  for several months, because of significant financial difficulty.’

‘As this is being reported from various LMCs this is obviously a huge problem, certainly considering the financial situation and also the change in the way practices are actually gathering income, such as the changes to enhanced services. This is all putting financial strain on and adding difficulty for practices.’

GPC deputy chair Dr Richard Vautrey said: ‘We are concerned by the increasing reports of practices and GPs in financial problems caused through no fault of their own. Our fear is that this is only going to get worse as NHS England pushes ahead with cuts to essential correction factor payments and slashes PMS funding. This alongside cuts to enhanced services, dramatically rising expenses and the interference of DH to annual DDRB awards means increasing numbers of practices will question their viability. This is all set in the context of general practice now only receiving 7.4% of NHS funding, which is not sustainable even in the short term.’

‘As we collect more and more specific examples of practices facing financial meltdown we will be using these as reasons why both NHS England and DH need to invest in general practice as a whole to avert a serious crisis.’

It comes as the BMA has warned that margins are increasingly being squeezed in GP practices as the proportion of funding that went towards paying expenses rose from 59% to 62% since 2008/09.

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Readers' comments (68)

  • A taste of things to come sadly

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  • The downside of owning your own business

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  • We must inform our patient groups, cut back on staff, limit reception staff, cut back on salaried staff and just survive.
    Primary care is efficient yet is still being targeted, there is no fat in the system

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  • If your practice is in this position
    1. Cut staff
    2. Look at all unfunded work and stop it
    Ie if minor injuries is not funded redirect
    3. Engage patients to the situation
    4 . Reduce number of clinics
    If all else fails ... Hand back the keys!

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  • >The downside of owning your own business

    The real downside is having to deal with a monopoly supplier who is showing increasing incompetence in terms of basic business function

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  • The Department of Health is stealing these doctor's livlihoods. The doctors are seeing patients. They are working hard.

    They are not being paid for the true cost of the medical care that they provide . The number of consultations taken by patients each year has increased but GPs have not been paid any more money to cover this.

    If the Government lets these practices go under they will still have the need to provide medical care for their patients. They will find it costs them more than they were prepared to pay those practices. Why not support these practices and avoid the pain and upheaval to their patients ?

    If they close there will be a domino effect on surrounding practices.

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  • Dear Anonymous | 06 March 2014 10:23am, you say - We must inform our patient groups, cut back on staff, limit reception staff, cut back on salaried staff and just survive. You do all that and you will NOT survive. Apart from which you should not be over-staffed at any time and read up on forward planning

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  • Be careful and support your GP colleagues as in previous articles neighbouring practices close Local Area Teams will expect local practice to absorb the patients - Refer to previous articles in Pulse where LATs have refused permission to close lists!! NHE trying have cake and eat it me thinks

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  • This is constructive dismissal -pure and simple . Virgin is waiting in the wings .

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  • If you cant pay yourself a reasonable wage then its pointless to carry on. Shut the practice down and work for a good wage and limited hours for whatever replaces it. This will keep happening till our leaders don,t plan to go the dentist way.

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