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Practices' redundancy and premises costs could be covered in CCG's merger drive

Exclusive GPs could be bought-out of their premises and have their staff redundancy costs covered in one of the most radical plans to encourage practices to merge yet. 

NHS Hull CCG is aiming to bring its 55 practices together into eight ‘practice groupings’ throughout 2016, and has identified a range of support measures to enable this, including ‘exit packages for staff’, paying legal fees and funding new clinical schemes. 

In return, the practices will provide seven-day working and will work in multidisciplinary teams.

It follows on from similar plans in the South West, where practices are being given funding worth up to £40,000 each to help them merge, while commissioners across the country are trying to incentivise working at scale in line with NHS England’s plans.

However, the plans in Hull go the furthest yet. The model, set out in the CCG’s primary care ‘blueprint’, was created in response to the significant undersupply of GPs in the city, which is 50 whole-time equivalent GPs short compared with the national average of 60 GPs per 100,000 people.

The CCG has implemented several schemes to increase recruitment in the city, such as a failed ‘golden handshake’ scheme, and even considered a move to a fully salaried GP service.

But the latest strategy is pushing towards changing the make-up of the practices in the city, in part by using the Government’s ’transformation fund’, which was originally intended to improve GP premises (see box).

The blueprint states that the first step towards sustainability for practices is to improve premises and retain current GPs as part of their move towards larger practices.

In order to do this, practices will be given support including: ‘Exit packages for staff, including GPs; estate solutions eg. buy-out of estate once alternatives are confirmed and secured; new clinical schemes with financial support to deliver services; IT alignment; set-up costs; legal fees.’

An NHS Hull CCG spokesperson told Pulse the funding would be drawn ‘from the CCG’s allocation, NHS England Primary Care funds and the Primary Care Transformation Fund’.

They added: ‘We have modelled the future landscape of primary care based on eight practice groupings, however it will be for individual practices, as independent contractors, to confirm the final configuration.

‘There is not a deadline [for practices to form groupings], however the CCG and NHS England will be working with practices and practice groupings throughout 2016 to support the development of the new models of primary care.

GP leaders say they expect changes to proceed slowly.

The chair of Humberside LMCs, Dr Russell Walshaw, told Pulse: ‘I think the management of the CCG would like to push on, but they recognise – because we keep telling them – it’s a membership organisation. The members decide how it goes, not the managers who they’ve appointed.

’People are changing their views [on merged working], as they start to see the benefits. But it’s a very slow process and if NHS England and the CCG is going to put money in it, that’s fine, it will need money. But it’s in very embryonic stages at the moment.’

Pulse revealed a similar plan to incentivise practices towards mergers and working at scale across the South West, with a £1.07million fund being set up by NHS England’s South West area team. The leaked plans seen showed that £40,000 was being invested in one merger of 13 practices, and ‘programme management’ to address innovative new services and offering unified care across the group.

What is the ‘transformation fund’ about?


Money JClaxton 330x330 - Online

Money JClaxton 330x330 - Online

The £1bn Infrastructure Fund was launched in 2014 by chancellor George Osborne to fund a national upgrade of GP premises. Practices had been asked to submit bids for a share of the first tranche of money - £250m - in January last year and more than 1,000 were given approval in March.

But Pulse revealed that area teams were reneging on funding they had pledged last year, claiming that practices were not ready to proceed with premises upgrade. 

Shortly after, NHS England announced that the scheme had been overhauled, and practices would now be required to submit proposals that were aligned to their own CCG’s objectives.

The bids for the next tranches of money would be judged on certain criteria, including: 

  • Increased capacity for primary care services out of hospital;
  • Commitment to a wider range of services as set out in commissioning intentions to reduce unplanned admissions to hospital;
  • Improving seven-day access to effective care;
  • Increased training capacity.

But the GPC has warned that the overhaul of the scheme would see funding meant for GP premises ‘siphoned’ off into other projects.


Readers' comments (14)

  • NHS managers just don’t seem to get it. GMS Practices are separate businesses, it’s like asking to Sainsburys, Asda and Tesco to federate for the benefit of customers, why would they do it?
    At least they are now offering to buy practice premises’, which will allow some GPs out of the millstone around their neck and so consider different options. However, their salaried pay would have to match their previous profit income.

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  • The money was never meant for the 'run of mill' GPs. I was refused a stair-lift in the Practice which could allow patients and disabled staff to access the meeting room on the first floor while being granted a permission to spend £5k minimum on replacement of 3 taps and wash basin.

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  • This comment has been moderated.

  • "National average of 60 GPs per 100,000 people". This is an average list size of 1,667! I don't know any practice with list sizes this low and any that do I would have thought were those likely to be having finacial problems and merging, or maybe I'm wrong?

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  • Desperation speaks. Sure part of the money will be given in a manner that it returns to the Tories to fund hotels for their next election campaign (BBC report on Tory electoral fraud last night)

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  • It's a ploy to bring about the demise of independent contractors in General Practice, and enable a govt stranglehold with massive workload and low pay. The trouble is, GP's are falling for it. 👽👽👽👽👽👽

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  • Yes, Steve Benjamin, I agree there needs to be a reality check of these data.

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  • 1027: "which is 50 whole-time equivalent GPs short compared with the national average of 60 GPs per 100,000 people". A little unclear but I think they mean 50 WTE GPs short with an average of 60 GPs (headcount, not WTE)/100k people. We've been told the official figures say something similar for us yet, in fact, we are around the more traditional 2000/WTE when calculated in a meaningful way!

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  • 9.58 am you are correct. every practice is individual business. list is based on where practice is. it is a competition for clients. collecting all at one place and offer more local services is what used to be cottage hospital.
    it would be good if ccg can buy premises which is a blanket around neck of single handed practice and other practices who have one owner.

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  • Cobblers

    This does not address the fundamental problems. Lack of GPs. How is joining up to form monolithic structures in any way going to help with GP availability? Big organisations especially nationaised ones tend to get ossified, slow to react, take their eye off customer care.

    Pankaj get back to work! 11:17am and on the internet? Tut! :-)


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  • Wish we had been given that opportunity last year . Out redundancy costs were£100000 , then £250000 to pay off the mortgage . No help offered whatsoever .i have let it go now

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