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Practices losing more than £3 per patient to be eligible for funding support

NHS managers have outlined a string of strict criteria for practices to receive funding support as a result of changes to MPIG following the decision to delay cuts for two years.

NHS England (London) said today that only practices that are losing more than £3 per patient as a result of the changes to MPIG will be eligible for the two-year reprieve from the funding cuts announced this week, while practices where partners earn more than £106,000 will not qualify for support.  

Other criteria include no contract breaches for any reason issued since 1 April 2013, and expenses must be more than 63% of turnover.

The decision to offer a reprieve to MPIG practices came after campaigning from GPs and patients in affected areas, and followed Pulse launching its Stop Practice Closures campaign.

A letter from NHS England’s London head of primary care commissioning Neil Roberts, addressed to London LMC leaders, said that the measure was pending the outcome of the review of the Carr-Hill funding formula to better account for levels of deprivation.

Terms to be eligible to apply were outlined as:

·         a reduction in GMS global sum funding greater than £3 per weighted patient in 2014/15;

·         no doctor in the practice declaring pensionable earnings in excess of £106,100 per annum, with a pro rata adjustment for part time GPs (the England average for 2011/12);

·         practice expenses evidenced as greater than 63 per cent;

·         no contract breaches for any reason issued since 1 April 2013;

·         fewer than half of contract holders having “live” cases with NHS England performer machinery or GMC, including the Interim Orders Panel

·         fewer than five outliers on the GP High Level Indicators (GPHLIs) on the current system;

·         evidenced extenuating circumstances within the practice population related to patient demographics that impact on practice workload - defined as an IMD score of 35 or higher for the practice population.

The letter said: ‘[P]ending the outcome of the review of the national funding formula, the London region of NHS England, in discussion with NHS England’s national primary care team, proposes to offer financial support to those practices that are losing more than £3 per weighted head of patient population from GMS funding changes in 2014/15 and where the current funding formula may not provide sufficient sensitivity to local patient needs.’

The letter said the interim solution, which will apply for 2014/15 and 2015/16, had been worked out based on meetings with affected practices.

It continued: ‘Both in London and in other parts of the country, one of the main themes to arise from these discussions has been whether, in some specific cases, the Carr-Hill formula may not sufficiently reflect relative practice workload because of specific demographic factors, particularly in relation to levels of deprivation. Work is currently underway nationally to review the Carr-Hill formula, specifically with a view to giving greater weight to deprivation factors.’

Mr Roberts said he would have posted a letter to each practice set to lose more than £3 per patient by the close of Tuesday of this week (12 August) and practices must sign an agreement with the area team by 30 September to remain eligible for the funding. He also said the identity of the practices would remain ‘not in the public domain’.

Readers' comments (13)

  • In other words a pay cut!

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  • HELP JUST UNTIL AFTER THE NEXT ELECTION HAS SETTLED DOWN AND BLOWN OVER THEN HUNT CAN BLAME SOMEONE ELSE WHEN HE PRACTICES ARE FORCED TO CLOSE IN DEPRIVED AREAS MENAWHILE HIS POSH SURREY PATIENTS ARE SHIELDED.

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  • the criteria is a nonsense- too many restrictions- this is a typical political gesture to pull wool over public eyes. Yes- an election gimmick!!

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  • These are very poor terms which I expect most struggling practices will struggle to meet anyway. They should close.

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  • When we voted for the new contract in 2004 it was upon the assurance that MPIG would remain in perpetuity. Reneging on this deal is unacceptable. It is also unacceptable that only the biggest losers are protected, leaving the rest of us in the mire.
    And if the truth were known, it is the Carr-Hill formula which is itself not fit for purpose - indeed, it never was, which is why we had to have the lash-up that was MPIG as some sort of compensatory measure in the first place. (If you remember, the original Carr-Hill formula delivered a lower gross income for 90% of practices when it was first introduced.)

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  • Of course the government has reneged on MPIG. There is no historical memory among politicians, only among the bureaucrats, who hate us

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  • Does anyone ese feel that the criteria have been carefully designed to make sure that no practices will be included?
    "a reduction in GMS global sum funding greater than £3 per weighted patient in 2014/15;": just in 2014/15?
    And particularly this:"evidenced extenuating circumstances within the practice population related to patient demographics that impact on practice workload - defined as an IMD score of 35 or higher for the practice population."
    What *is* an 'IMD score'? how is the practice xpected to 'evidence' it? and will it allow rural and student practices to qualify for this 2 year temporary relief?
    "The devil lies in the detail" - and so far, NHS England has been very very legalistic...

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  • A SINGLE HANDED PRACTICE WITH BIG LIST BUT LOW WEIGHTED LIST WILL NOT QUALIFY BECAUSE ONE DOCTOR WAS WORKING FOR TWO TO BOOST INCOME.
    IT SHOULD BE BASED ON NATIONAL AVERAGE LIST SIZE. NOT ON ONE GP'S INCOME

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  • 'She's the dollars
    She's my protection
    Yeah she's a promise
    In the year of election'
    I'm sure we'll see more promises that fade AFTER the election! DIRE

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  • They have spent months looking at the practices facing closure and working out conditions which will restrict payments to an absolute minimum number of practices.

    As said above, just enough to fend off closures until after an election - then they have another 5 years to scr@w over Primary care and finish off their privatisation agenda.

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