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A faulty production line

At last, some honesty over MPIG

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A leading NHS England official has admitted that some practices will close over the MPIG-changes. Now practices need to know what support they can get, says Pulse chief reporter Sofia Lind

NHS England is willing to let GP practices close as a result of the ongoing redistribution of GP funding, says primary care commissioning lead Dr David Geddes. There we have it. While not a nice thing for GPs to read, there is a sense of relief that, at last, somebody in NHS England is telling it like it is, rather than giving opaque promises that somehow practices will be protected, leaving GPs to pick apart and guess what they mean.

We were wondering what was going on with area teams supposedly protecting outliers, because this didn’t seem to be materialising on the ground, anywhere across England. Dr Geddes says that actually, area teams are supporting practices, but not financially. Area teams are eager to help practices find efficiency savings, advice on merging, federating and networking. This is the kind of thing you can turn to your area team to discuss at this moment in time.

We had thought that NHS England would commission extra services on top for practices that may be struggling with the funding redistribution, in order to keep them viable. Dr Geddes says no, NHS England will not be creating ‘another MPIG’, some money-for-nothing funding just to keep a practice viable. We can stop expecting this. The ‘cheque book’ is not coming out.

Now we are wondering, is that cheque book never coming out? Never say never. According to Dr Geddes, a practice that provides a service vital to patients will, eventually, be protected. The question is whether it is actually NHS England’s cheque book we are talking about.

In our interview, Dr Geddes said that practices who have ‘identified an additional service they provide, or quality they can deliver, then actually we want to work with the CCGs in establishing better ways of managing that.’

Perhaps there’s a tiny bit of guess work still left to be done, but if I were to make mine, I’d say it’s worth keeping an eye on this whole thing with CCGs co-commissioning primary care, the ‘call to action’ on general practice and the CCGs’ ongoing work with developing five-year plans for the local health system, should you want to see that proverbial cheque waved in your practice’s direction. 


Readers' comments (6)

  • This is both incredible and disgraceful. It is akin to constructive dismissal. It therefore doesnt matter if it is their policies that have rendered otherwise efficient and excellent practices like our own unviable? 'Tough' is their response. Is the profession really going to lie down and take this? REALLY? Doesnt everyone realise that if they can do this to a practice like ours (and by the way we already have done ALL of this stuff they say they are going to help us with), they can do it to you? And they will. Bit by bit they will pick us off. If this doesnt want to make you call for mass strike action to alert the country to what they are doing (and more), what will?? Please tell your patients- NO ONE IS SAFE.
    Naomi Beer (Jubilee St Practice, London)

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  • I agree with Naomi Beer.

    The Government has engineered the conditions that have made these practices unviable. It is not as if practices are not working hard. They are seeing the patients and probably seeing 30-40/day. The problem is that the Government is not paying the market rate.

    When these practices close, their patients will still need medical care. Who is going to provide it and at what price ?

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  • Perfect storm!
    An engineered crisis, based on a fake funding model. Dispersal of lists will follow..perhaps we should refuse to accept the allocated patients, based on poor premises, poor recruiting and their own CQC criteria.
    We all know that APMS cannot do even a 1/3 of our workload for £60 per head pa. Time for some market testing. The cost to the govt for buying primary care will go up, whatever happens next!
    Bring it on, if that's what you want. Market forces are on our side: the exchequer is really dumb!

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  • Underneath all of this is a government wish to get us out of the NHS pension scheme. If we did that en-masse, and set up our own mutual portfolio, they would leave us alone, AND it would completely blow their budget as there would be no incoming contributions to pay for the current retired incumbents!

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  • An arcane system of calculations. There is something inherently wrong with a system of payment where one goes bankrupt seeing over 40 patients a day and 12-13 hours of work. How can you recruit into a profession that cannot protect you from bankruptcy even if you are worked to the bone. If GPC can stand by and watch practices go to the wall without even seeking an opinion on mass resignation - then one wonders where they true allegiance lies. They are the reason for this mess. Time for backbone, even it means leaving.
    We get £ 60 / patient year. South of our border it is 70 euro to see a GP once!!!
    We really should be looking at a different model if we are going bankrupt doing 13 hour days.

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  • Rather than a strike - which will be portrayed as grasping GP's wanting more - why not close all lists . This will have a rapid effect even if we have to take a short term financial hit .

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