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GPs face funding shortfall as council threatens to stop paying for Health Checks mid-year

Exclusive GPs in one area could be forced to lay off staff or cut services after the local council threatened to stop paying them for the national NHS Health Checks programme mid-contract, local leaders have claimed.

Hertfordshire County Council told the LMC it wanted practices to stop providing Health Checks, meaning it would only pay practices for the activity carried out to 20 October – even though practices have taken on and trained extra staff specifically for the programme.

Local leaders have warned that the council is threatening to spin any protest as GPs jeopardising public health services because of their own self-interest.

But the GPC has said this amounted to ‘moral blackmail’, and that it showed the Government claims that NHS funding would not affect frontline services had been misleading.

The LMC has vowed to fight the council’s attempt to force practices to accept the deal.

Under the Health Checks scheme, practices are paid to call in patients aged between 40 and 74 years, who have not already been diagnosed with vascular disease, diabetes or renal disease, and carry out a vascular risk assessment.

As a public health enhanced service, it is now run by local authorities, who may commission GP practices or other providers such as pharmacies to run them. As part of this, Hertfordshire County Council had a deal with local GP practices to run the programme for 2015/16.

However, the council has now written to GP practices to request the change in their NHS Health Checks contract.

Dr Peter Graves, chair of Hertfordshire LMC, told Pulse: ‘The council have written to practices asking them to have a mid-year change of contract – they are only prepared for what’s been done to date.’

Dr Graves said the LMC was fighting the move, but the council has warned GPs about the consequence of protesting.

He said:  ‘The contract says it can’t be changed without both parties agreeing, so we are clearly going to fight this. They are threatening that this will go into the public arena as, “GPs potentially jeopardising public health services by putting their own personal interests first” , but they are not factoring in that this will jeopardise GP services.’

Dr Graves added: ‘GPs will plan their services based on a year’s income – so if they have taken staff on they either make those staff redundant, or they’re having to pay salaries that they are not going to be reimbursed for - so somewhere else in the system, something has to give.’

A spokesperson for Hertfordshire County Council said: ‘We are currently in discussions and it would be inappropriate to comment further. It is not our intention to terminate contracts.’

Dr Bob Morley, GPC negotiator on contracts and regulations, said the council’s action amounted to ‘moral blackmail’ and practices should take legal action if they end up carrying out unpaid work.

Dr Morley said: ‘It seems the Council is putting moral blackmail onto practices either not to do the work or do the work without any funding – either way it’s totally inappropriate.’

He added: ‘Quite simply, practices it they carry out the work must be paid under the contract, and if the local authority refuses then they may have to take legal action against it.’

The threat to cap funding of NHS Health Checks comes after the Government announced £200m cuts in public health funding earlier this year, which the Treasury insisted would come from projected budget surpluses and would not affect frontline services.

Dr Richard Vautrey, deputy chair of the GPC, said the move showed ‘how misleading the statements from the Treasury have been about not cutting NHS funding’.  

Pulse reported that an independent evaluation of the scheme found that it only reached only a fifth of its target population over the first four years.

Readers' comments (18)

  • ha ha ha.
    Climb into bed with politicians whether national or local ones, and you will get shafted.
    The only hope for doctors and medicine is to go private and rid yourselves of the interference of slimy policitos.

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  • Hmmm...now what would have happened if GP surgeries wanted to put prices up mid way through the contract?

    If I was one of the affected surgeries I would have NO hesitation in writing to patients cancelling their appointment stating that this was due to funding being stopped by the council.

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  • "If I was one of the affected surgeries I would have NO hesitation in writing to patients cancelling their appointment stating that this was due to funding being stopped by the council."

    Agreed and find other services that the practice can cut and link that to the funding too.

    In my practice (like many others) income from health checks helps fund things like phlebotomy and ECG. I would cut the number of phlebotomy appointments and tell patients they cannot have their blood tests because of cuts by the council.

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  • At last some enlightened publich health person daring to stop this clinical nonsense of NHS health checks.

    However, it is not right to change this midyear, an adequate notice period to the end of the financial year would be more appropriate.

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  • If you have a contract then enforce it, through court if needs be, and stop complaining about the Council using news media and moral blackmail, make the first strike with a press release stating that the council is reneging on a contract and putting the future of GP surgeries at risk.

    Stop being such nicey nicey pansies and start fighting in the real world. If GPs won't stand up for themselves then they won't get and don't deserve any sympathy.

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  • Actually, we are enormously powerful. Patients need doctors. They can do without politicians and papers. It is only our care and compassion that allows us to be so treated. We can resign and charge them at the door.
    Our profit per patient is £ 60 in NI. If you factor in paperwork, tax, NIC etc - take home pay per consult is abou £3.00
    Perhaps it is time to stop being so altruistic and charge rates as all equivalent professions do.

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  • Gps should not face funding shortfall due to previous PCT's wastages.As an example the PCTs started experimental faulty error recording and involving prescription issued by default by them,collapsing and freezing thrice in a consultation,rendering it impossible to check the scripts without unacceptably keeping patients waiting.Computer systems like Alt GP costing millions to national economy only to abandon it.They imposed on GP non cost effective drugs like sulfonylureas whose immediate treatment in secondary care according to Prof Tony Barnet costs hundreds to thousands pound each case.
    They destroyed thousands of qualified trained GPs by referring them to a compliant GMC MPTS,driving GPs in droves to Australia,New Zealand and even bankrupt Greece to escape NHs clutches.
    The long term side effects of Sulphonyureas associated with weight gain included Blindness,MIs CVA,Amputations due to blocked arteries,Renal failure which exorbitant costs to National Economy is now being unjustly imposed on GPs.
    According To Prof Brian Jarman and Prof Michel Hands in BMJ Editorials 'When Managers rule Patients may suffer (BMJ 2012;345:e8239 and letter by the later ' BMJ 2013;346f209'We need aggregated Data on bullying in NHS'costs should be passed the directors,be they Medical qualified or not,not to the subservient GPs

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  • I agree that the contract should not be stopped mid-year, after all, a contract is a contract. However, most of what I have read about NHS Health Checks in Pulse over the last year or so, has all concentrated on saying what awaste of time the checks are. Well are they a waste or not (rhetorical question) Come on guys, stick to a line otherwise you make yourselves look foolish and indecisive to the politicos.

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  • This article is on the same webpage as an article saying what a waste of time Health Checks are.

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  • I take it Public Health funded the testing equipment (circa £2.5k) as they did in Surrey. So if they renege on the contract, keep the kit and sell it on to regain your losses!

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