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Small practices worst hit by MPIG phase-out

By Gareth Iacobucci

Small practices with only one or two partners will be those hit hardest by the phase-out of the MPIG, and will gain least from the new pay deal, a Pulse analysis suggests.

Single-handed GPs dominate a Department of Health list of practices most reliant on the MPIG, with a slightly larger than expected proportion being in deprived areas.

The make-up of the list – released to MPs earlier this month - suggests there is a pattern to heavy reliance on MPIG correction factors, and that the new pay award is likely to financially disadvantage a certain type of practice.

Pulse last week revealed the three quarters of practices still wholly reliant on correction factor payments would receive only around a 0.7% increase in core income, compared with 2.4% for the 10% of practices wholly reliant on global sum.

The GPC has warned this year's deal – with its differential uplifts for different components of the contract - is ‘potentially unfair' to some practices, and admitted to widespread confusion over exactly which will gain and lose.

But there is a pattern in the list of 67 practices whose correction factor payments are more then 25% of their overall income, with 57% being single-handed and a further 21% having only two partners.

Over a third of practices on the list are in the most deprived quarter of areas in the country, in places such as Tower Hamlets and Newham.

But more affluent practices are hit too, in areas such as Southampton and Cambridgeshire, with almost a fifth of the list in the lowest quartile for deprivation.

Dr Chris James, a GP at the University Health Centre in Southampton, which features on the list, said his practice would be taking a huge hit overall when also taking into account QOF prevalence changes.

‘I was one of the minority that voted No to the new contract. My worries have borne fruit. It's disappointing to have a variable pay award which depends on the practice you're in.'

Dr James said staff costs and reimbursements pre-dating the new contract were one reason his practice was reliant on the MPIG.

Dr Peter Swinyard, joint-chair of the Family Doctor Association, said small practices continued to be ‘in the firing line' of the Government.

‘Yet again we have a cost pressure on smaller practices which I'm sure the Government isn't too unhappy about,' he said.

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