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Further GP practice collapses ‘inevitable’ as £1m is cut from QOF payouts



GPs in Northern Ireland are set to lose a million pounds from next week after health chiefs refused to adjust the funding formula.

The calculation for QOF points set this year’s funding at £29.4m compared with £30.4m last year, says Northern Ireland GPC chair Dr Tom Black.

A ‘statistical quirk’ is to blame for the shortfall because of a high number of mergers, which has seen list size increase, he explained.

Since a similar problem occured in England in 2014, adjustments have been made to protect funding, with the value of a QOF point increasing by 3.6% from April in England.

But yesterday Dr Black received a phone call to say the Northern Ireland Department of Health was sticking to the letter of the contract calculation, with no uplift to the value of the QOF point, despite GPs already facing huge pressure due to lack of funding.

Dr Black calculates that 80% of practices will lose thousands in funding, saying practices closures and further collapse of services was ‘inevitable’.

‘It is extraordinary,’ he said. ‘And it is a kick in the teeth for GPs who are only in this situation because they took on other practices and merged to help protect services.

‘You do not take a service that is in crisis and cut funding because of a statistical quirk.’ 

Dr Black and colleagues had been in discussion with the department for a number of weeks over the issue and had hoped a solution could be found.

He said the department’s justification was essentially that ‘it is in the contract and this is how you calculate it’.

‘They decided not to fix it, now the average practice will lose thousands.’

The calculation in question – the contractor population index – is based on the average practice list size.

In England adjustments have been made to reflect changes in list size and overall population growth and Dr Black said that ‘funding evidence coming from our accountants indicates that we’re being funded at a rate of £101 per patient per year compared to £142 in England’.

He added: ‘GPs across Northern Ireland will be rightly furious about this decision and are now being forced to take further action. We will bring a possible action GPs can take to our NIGPC meeting on Wednesday, outlining how practices can make cutbacks to their services equivalent to the cuts in funding that they will now suffer.’

It comes as practices in Northern Ireland are on the brink of collapse, with the BMA taking the unprecedented step of collecting undated resignations after a vote showed GPs were willing to walk away from the NHS.

GP leaders had already warned that 6% of practices could close this year and general practice would likely collapse before the collection of resignations was complete.