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Minister offers practice ‘short-term’ emergency payments to keep it afloat



Exclusive A practice facing closure due to the changes to MPIG and QOF says it has been offered the chance to apply for emergency payments to ensure its survival from NHS England during a private meeting with a health minister.

The Jubilee Street Practice told Pulse it had been told there may be additional funding available from NHS England to help their financial situation, but that they had to submit a business case.

According to the practice in Tower Hamlets, east London, health minister Earl Howe suggested at a meeting at their premises on Tuesday that they apply for a ‘short-term, fixed’ payment to supplement the services that they provide above the core contract.

The practice – which has made national headlines after it mounted a campaign to ensure its survival following the loss of hundreds of thousands of pounds from the changes to QOF and MPIG this year– says they have until next Monday to apply for the funding, which will be confirmed in July.

GP leaders have said that ministers and NHS England must extend this offer to all practices at risk of closure as a result of recent changes to the GP contract.

The move marks a significant change of tone, as NHS England head of primary care commissioning Dr David Geddes told Pulse last week that NHS England would not be bringing out ‘the cheque book’ to provide ‘another small MPIG’ to practices destabilised by funding changes.

Dr Geddes also attended the meeting and – according to the practice – said that the first year of additional funding from NHS England would support the additional services they provided above and beyond the core contract, such as caring for a deprived population and translation.

Subsequent year’s funding would have to come from the CCG, Dr Geddes added.

Practice manager Virginia Patania told Pulse that Earl Howe proposed a ‘two-tiered’ approach to keep the practice afloat after it suffered losses of £75,000 last year and expected losses this year of £95,000 this year – a budgetary gap of £7.64 per patient.

She said: ‘There was a very strong commitment to not let good practices that had been severely affected by MPIG-related changes in funding to go under, and Earl Howe was quite clear on this, from a ministerial perspective.

‘He suggested a two-tiered approach, one being a short-term, fixed [payment] to supplement practices that for whatever reason, deprivation or what have you, are not able to cover core services with core funding […] with a longer term commitment to actually review the capitation funding so that practices in more deprived areas, such as Tower Hamlets, wouldn’t be as penalised by the change in the funding formula as they had been in April.’

She added: ‘What they are thinking is for this year the money would need to derive centrally, from budgets that I am not familiar with, but that next year it would likely come from a co-pooling with some of the budget to be derived centrally, but the rest would be a mixture of CCG, public health, council, so the co-commissioning model. So I think they’re basically delaying it to the co-commissioning next year and trying to save our bacon this year.’

‘There is definitely movement, finally we are hearing [there will be] financial support, but who will get it, what you need to do to apply for it, what you need to demonstrate and how much that will be, is all up in the air basically, until the 20 July.’

The Jubilee Street Practice led Tower Hamlets GPs and patients in a protest march against funding cuts yesterday and was featured in national newspaper coverage of the cuts to MPIG.

The GPC said that all MPIG-reliant practices should be allowed to apply for additional funds, as promised by NHS England before the phase-out began this April.

GPC chair Dr Chaand Nagpaul said: ‘This approach should not just be taken with the Jubilee Practice but it should be taken across all the significant losers, so that they are not being penalised because of the vagaries of a formula. NHS England needs to make sure it happens for all of those practices, not just for a few.

‘That is what NHS England committed to doing so I think this is what should have been happening at the outset. There should have been a proactive approach, rather than now, [responding to] a campaign.’

A Department of Health spokesperson said: ‘It was agreed that Dr David Geddes, Head of Primary Care Contracting from NHS England, would meet with the practices individually to discuss a range of possible options to address the  challenges they are facing. We understand that NHS England will look to make decisions on the way forward in the next few weeks in light of these further conversations.’

NHS England was not able to respond in time for publication.