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Dr Robin Hollands: ‘After fifty years of university practice, it’s no longer affordable’

We’ve got ten thousand patients, of which three and a half thousand are students at the branch surgery. 

So the issue is about whether we have to pull out of university practice – which is very difficult after 50 years of association with the university.

We don’t have to do it at the moment, we’re a PMS practice, and we’re protected by PMS funding. But that is being eroded, so we’ve got to look at this global sum issue. 

And the problem is, the way I calculate it, we get about half the global sum payment – which we don’t think is affordable to run a branch surgery.

We understood that PMS was designed for our sort of practice. It was trying to protect us from this problem. The problem is now, huge financial pressure is being put on practices like ours. 

For example, we’ve lost £40,000 pounds into global sum after the the changes to QOF points this year.

So we’ve got to make a financial decision at some point. We don’t want to pull out of university, but the problem is we have to make that decision as to whether it’s affordable. Because we’ve got to run a business and we have to pull out.

The concern I have is, what happens to the group of students who are quite vulnerable? We’ve got quite a high percentage of patients from abroad, who don’t understand NHS services. We’ve got students who need to be encouraged to register with GP surgeries.

Obviously another practice might take up the health centre, but I’d be surprised because it’s not a profitable thing, and if no surgery takes it up the concern is that students will start using unscheduled services because they won’t be registered.

So it’s a real problem and we don’t know what the answer is really, because there doesn’t seem to be any political will to look at the workload of student services.

Dr Robin Hollands is a GP in Gloucestershire