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Independents' Day

Letting practices 'wither' is a complete dereliction of duty

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After months and months of Pulse highlighting the plight of hundreds of vulnerable GP practices across the country, now this.

Pulse and the BBC have obtained a leaked briefing note from an NHS England director in Yorkshire and Humber that reveals a secret strategy to allow practices to ‘fail or wither’.

‘We are no long in a position to continue to support practices irrespective of their willingness to transform,’ it says.

What a scandal. A complete dereliction of duty. Each practice that closes is a tragedy, for the partners and the patients, and is a further kick to the knackers of a health service that is already struggling to cope.

You cannot tell them to ‘transform’ when they are struggling to survive. Transforming takes head-room, time to think and plan.

Look at this one in Warwickshire: the partners are being forced to choose between taking out significant personal loans or declaring bankruptcy to cover the liabilities they have been left with after handing back an unsustainable contract.

Do you really think they were saying towards the end: 'Hm, how about a bit more social prescribing?'

NHS England says the leaked document does not reflect national policy, and to his credit, Dr Arvind Madan, director of primary care at NHS England, did admit errors, telling the RCGP's annual conference that they had not been good at 'getting the money out the door to practices that are in trouble’.

But practice closures have hit a three-year high, with 200,000 patients displaced last year and, as Pulse recently revealed, a £10m national fund for vulnerable practices has been tied up in so much red tape it has yet to reach the front line.

As Dr Zoe Norris points out in her blog today, NHS bosses have a choice here. They have the funds from the GP Forward View so there is no excuse for holding onto them and not passing it onto practices in trouble.

Because if they don’t, then the implication will be clear. They wanted it that way.

Nigel Praities is editor of Pulse

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Readers' comments (22)

  • Why is the NHS director allowing the NHS to wither... Why is he being paid to let the system under his control fail?

    And who is the "We" which was mentioned? Was it all the other NHS directors/Government?

    So this says that the aim and policy for the top brass of the NHS is to let the NHS system wither and fail by targeting a critical part of it?

    Can I get a job like that? Could I get a bigger bonus if the NHS fails faster? I see there is now also the possibility of a gong too if I bring it down really fast!

    Please please me too...... I can make a real dogs dinner of the NHS as well if allowed- well perhaps not one as Jezza but I can try?

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  • I am a trianed Industrial Engineer turned practice manager recently retired.Since 2004 the work load has doubled and the payment is increased by only 60%.However, all the work does not require tobe done by the doctor.If you have proper skill mix then you can make a decent living even now.However, you need minimum number of patients located under one roof.Thsi can can two or three GPs sharing resources like practice manager,nurse,HCA's and even reception staff.Your leaders have taken on public health duties which very profitable if delivered appropriately and claimed.This not possible in small practices.I had produced a model of resources needed for small practice to be as profitable as a larger practice and it show the funding for small practice need tobe 30% more for 1500 patients decreasing to nil for 3000patient.But now that number has moved to 6000 patients.No Govt which is under financial pressure is going to give additional payment to small practice.
    However,there is nothing in the rule book from two three practices working together! to maintain the old fashion family
    practice.Most of the so called family practice are in name only see their ratin from the patients surveys which are carried out every six months by MORI and on web.Everybody has excess to it. If you think that by joining a Fed you will be saved then you are living in koo moo land.

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