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PMS funding transferred to practices in deprived areas

A CCG has decided to shift almost £1m in PMS funding to practices that are disadvantaged by the GP funding allocations formula.

NHS Greater Huddersfield CCG has identified £986,968 in PMS ‘premium’ funding in the national PMS review – £170,000 of which it intends to reallocate to three practices disadvantaged by the Carr-Hill formula.

The CCG said the practices that will receive the payments includes a university practice with a high proportion of younger patients and two practices in areas with high levels of deprivation.

But it comes as a local PMS practice is bringing about legal action against the cuts, after being told it could lose £277,000 – 42% of its income.

CCG board papers said: ‘The payments GP practices receive under their contracts are calculated according to their practice list size weighted for a number of factors. In Greater Huddersfield it has been noted that there are three practices that are considerably disadvantaged by this process – University, Bradford Road and Thornton Lodge.

‘The reason for this disadvantage is that these three practices have a high percentage of younger patients and a high level of deprivation in the case of the latter two practices. The proposal is therefore that these practices should receive a payment that caps the difference between their weighted and raw list size.’

It comes as the Carr-Hill formula is currently being reviewed on a national level in a bid to change to to better reflect the costs of caring for patients in deprived areas.

The remainder of PMS money taken from Huddersfield practices will be used for enhanced primary care services for gynaecology, phlebotomy, care homes and polypharmacy, the CCG’s papers said.

But the CCG highlighted an ongoing dispute between NHS England and the PMS practice set to lose the largest amount of funding in the CCG area as a potential ‘risk’. 

The Slaithwaite Surgery 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 – 42% of the practice’s total funding.

In response one of their patients has launched legal proceedings against 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 board papers said: ‘The Primary Care Commissioning Committee is advised of risks to the amount of PMS premium funding that might be available to the CCG in 2016/17 and beyond.

‘Locally there is one practice (who would be the largest contributor to the Premium) who is in dispute with NHS England about the process and policy. The financial position for the CCG with regards to this funding is therefore unclear.’

GP funding redistribution

NHS England announced a review of 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 each area.

Meanwhile, changes to the Carr-Hill formula have been under consideration since 2007, partly because of concerns that practices with atypical populations, or those in deprived areas, do not receive sufficient funding to support them to treat their patient demographics.

Last year Pulse revealed that practices with ’atypical’ populations – such as rural practices and those treating high numbers of homeless people – could be given their own contracts under plans being discussed by GPC and NHS England.

Although practices in disadvantaged areas continue to push for the review to conclude, the GPC has repeatedly warned of the dangers of unintended consequences as there will be ‘winners and losers’ from any Carr-Hill rewrite.