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Independents' Day

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


Readers' comments (16)

  • Most University practices have it pretty easy; students there for 30 weeks of the year or so, go home to parents if really ill, no chronic disease management to speak of.
    In one local to me, the doctors mostly do off for 8 weeks in the summer and leave a skeleton staff.
    I shall not cry any tears.

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  • "We are open five days a week currently, from nine until five.- so not even doing the contracted hours of 0800-18.30 like the rest of us. get a grip!

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  • The situation always needed addressing .
    It's was fudged in the first instance.

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  • I work at a campus based surgery. The comments of 12.27pm and 12.29pm confirm the misperception amongst health professionals that students are an unchallenging group of patients to look after. The RCPsych College Report Mental Health of Students in Higher Education 2011 highlighted the high prevalence of mental health disorders amongst University students and the value of specialised student health GP services in patient management. Overseas students do not have the option of returning home to families for care when unwell and are heavily reliant on GP and nursing care in loco-parentis.

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  • We should be sticking together. If NHS England is happy to see a GP surgery close and have to pay redundancy payments with the potential for bankruptcy then we are all at risk.

    The GPC should be protecting the livlihoods of GPs. Why should a GP be out of pocket because of peverse decisions. They are working hard so they should be able to have a living wage. The only reason they do not is because the NHS is not paying them enough for their medical skills. A fee per consultation would solve this.

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  • agree with above - we need to unite.

    Dr Spears needs to do what is right for him, his family and staff.

    there are going to be many more surgeries in this position soon.

    i suspect some posts above are trolls and should be ignored.

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  • Our local university practice has some of the highest paid GPs in the CCG with full time partners gross earnings after expenses of £200k+. During the summer vacation they are able to operate using one GP. They do virtually no chronic disease management and perhaps a home visit once a month. I expect they'll be holding their hands out for the £5/patient for a named GP for the over 75s -despite having no-one in that age group.

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  • To those above with little common sense; please note... If practices fail, regardless of the historical financial picture, it will hurt everyone. Practices falling apart will refer more to 2ndary care, and send more to A&E. The impact of that on CCG budgets will be huge, and will prevent any quality payments being received, which in turn will restrict the local commissioning pot still further. Neighbouring practices will be destabilised as their MPIG-reliant colleagues shed capacity and patients look for someone else to see.

    Your petty in-fighting will only serve our political masters. If we are to see general practice survive, and the best interests of our patients served, you will need to wake up and work together. If this does not darken your door, the next issue will.

    It will only take two concurrent issues to cause havok in most medium sized practices.

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  • 11:15 has a good point - a 25% cut in my practices below average practice income would be a killer but to my dispensing practice colleagues it would just put them where I currently am.

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  • Gyre are special cases but let's face it, MPIG has been a cosy cushion for many underperforming practice's. We're stuck with 2 practices who more or less refuse home visits locally and force all their high demand patients on our list.
    Time to implement market forces and give equal opportunities.
    Get rid of the MPIG.

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