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Is your practice ‘vulnerable’?



NHS England has detailed a series of factors that together signify whether practices are ‘vulnerable’, and should therefore be prioritised for funding from their local area team. 

They include:

  • A CQC rating of ‘inadequate’ or ‘requires improvement’
  • Individual professional performance issues
  • A high number of patients per whole-time-equivalent GP
  • A high percentage of GP sessions not routinely filled
  • Low QOF achievement – specifically those practices with a score of less than 85%
  • High referral or prescribing rates – where a practice is in the upper quartile for aggregate prescribing performance or referrals when compared with the average across the CCG
  • A recent application for a list closure
  • Low GP Patient Survey scores for: ‘Would you recommend your practice to someone who has moved in to the local area?’
  • Low GP Patient Survey scores for ease of getting through to the practice by telephone
  • Issues with practice leadership (such as partner relationships) – the guidance admits this is ‘hard to define’ so commissioners will need to justify any risk rating
  • Significant practice changes – ‘splitting’ is of more concern than ‘merging’ as the latter may be for positive reasons’ and may make practices more ‘resilient’
  • Significant concerns from LMC, CCG or NHS England

Source: NHS England letter to area teams, 7 December 2015