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Practices making contingency plans to cut staff over MPIG uncertainty

Practices are making plans to cut staff or reduce GPs’ hours because of the uncertainty surrounding the future of MPIG payments, with the GPC criticising NHS England for failing to begin talks.

The Government is cutting the income guarantee payments over the next seven years by 13% year-on-year, with the first cuts to take place in April, but NHS England has said that it will discuss ways of mitigating the effects on practices that depend heavily on the correction payments. However, with five months left until the first cuts are made, there has still been no moves to instigate talks.

GPC chair Dr Chaand Nagpaul told Pulse he is concerned that NHS England has not set a timetable for discussions about the issue and that delays are ‘destabilising’ practices.

Dr Nagpaul said: ‘We need to get this issue sorted out quickly. It’s very unsettling for practices, and the last thing we need to do is destabilise them. Practices need to know where they stand as they try to budget for the short and long term. We haven’t had any discussions on how outlier practices will be defined and how they will be assisted.’

Dr Karen Massey, a GP from Slaidburn Country Practice in Lancashire, helped collect 3,000 names on a petition in protest at the MPIG changes, which Ribble Valley Conservative MP Nigel Evans presented last month to NHS England national director for commissioning development Rosamond Roughton.

Dr Massey told Pulse: ‘We have no idea where we are going at the moment. I can’t make decisions about staffing hours and my income at the moment because we don’t know what will happen in April.’

‘We will lose about £14,000 in the first year of the MPIG phase-out. We can manage in the first year by cutting my income and staff hours, but if we lose the same amount the year after that there is a definite possibility we could shut.’

Dr Julian Fester, a GP in Whitby, said that his practice has a contingency plan for working without a receptionist next year. ‘As things stand we will be losing £1,000 a month from April, so we are thinking of not replacing the receptionist when she retires. I’m hopeful that NHS England will sort something out quickly. Otherwise we will run into serious cash flow problems.’

An NHS England spokesperson said: ‘NHS England is committed to working with the GPC and other stakeholders on how to handle the very small number of outlier practices where MPIG payments make up a significant proportion of their income. This work is currently being taken forward and we will discuss this with the GPC shortly.’