Exclusive NHS England is facing a potential judicial review in the wake of PMS review cuts to a local practice that will mean a 42% reduction in its annual budget, leading to redundancies and reduced access.
Pulse has learned that other practices are also preparing to undertake legal action as they prepare to lose hundreds of thousands in annual funding, with the possibility of a class action.
Law firms have said the size of the impact on local GP services raises questions over NHS England’s consultation with patients about the changes.
NHS England announced a review of the ‘premium’ funding received by PMS practices that were not linked to specific services in 2013, in a bid to save £260m, which it said was set to be ‘redeployed’ across all GP practices in the area.
Pulse reported that accountants believed some practices would lose as much as £400k from the reviews, which have been taking place since April 2014
Many practices were given reprieves through deals that would see their funding gradually reduced over a number of years.
However, some practices are now facing up to cuts that will kick in from April 2016.
One practice, Slaithwaite Surgery, near Huddersfield, West Yorkshire has warned their nearly 5,000 patients that there will likely be reduced access, after it has spent two years fighting proposed cuts of £277,000.
In response one of their patients has ‘filed papers’ on NHS England, with the surgery saying they have ‘been advised that NHS England is acting unlawfully’ having failed to meet the patient consultation requirements in the NHS Act 2006.
The practice is also launching a website and campaign, Family Doctor SOS, which will give information for affected surgeries and patients.
Dr Paul Wilding, one of the partners at Slaithwaite Surgery said ’the budget cut is so extreme for us’, adding that it comes to around £277,000 – 42% of its budget – and they expect to have to cut their practice staff while caring for the same 4,838 patient list.
He added: ‘One of our patients has taken action with this judicial review – which we’re delighted with. That’s the collateral benefit of sounding things out with patients, asking if they’re annoyed by this and are they prepared to fight? Well the answer is people want to get tooled up, they’re furious about it, and one of them [who is asking to stay anonymous] has gone and filed papers on Simon Stevens.’
He also said there had been indications this was happening elsewhere.
Dr Wilding said: ’At least two other practices/patients nationally now taking legal action against NHSE/government for failure to consult regarding enforced service change/failure to consult. End result may be a class action.’
NHS England declined to comment on the legal action, but said: ‘The purpose of local PMS reviews is to ensure that PMS funding is aligned to services for patients and that where it isn’t, it is reinvested into GP services in that CCG area.
‘PMS reviews will not reduce the overall level of GP funding in each area.’
However, Dr Wilding said this would likely be in the form of incentives schemes.
He added: ’We cannot keep GPs and nurses on in the assumption that we might meet incentive scheme requirements (despite less staff). Regardless, if we lose £280,000 and then try to win back £25,000-£30,000, we are still holed below the water line.’
Meanwhile, in Bristol, Concorde Medical Centre has also learned they will lose £240,000 annually, after the NHS England review said they were not providing the additional services identified in their PMS contract.
Practice partner and former Avon LMC chair Dr Simon Bradley said this will lead to a big reduction in appointments offered.
He said: ‘[The premium loss is] getting on for £240,000 over five years. That funds 18,000 appointments in my practice a year, that’s the whole of our nursing team, or it’s two GPs. It will mean our practice will have to reduce between 14,000 and 18,000 appointments a year.’
But a spokesperson for NHS England South West said that the redistributed funding would mitigate this with more than half the amount being reinvested and all practices would benefit.
They said: ‘The figures quoted [by Concorde Medical Centre] takes no account of the reinvestment of all PMS premium funding by the CCG back into local practices which will reduce the impact to less than half the amount quoted.’
‘Practices which through higher funding have been able to deliver extra services to their patients may have to change what they offer.’