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Local areas fail to protect GP income from Health Checks and LESs


Exclusive One in ten GP practices are missing out on funding for NHS Health Checks and local enhanced services (LESs) because commissioners are failing to protect income against national guidance, the BMA has revealed.

At the start of the pandemic in March last year, NHS England said that GP practices would have their LES income protected, alongside income protection for QOF and DES payments.

And in January, it reiterated that LESs should be suspended with income protected, except ‘where these are specifically in support of vaccination’ or other Covid activities.

But the BMA’s latest tracker survey has revealed that more than one in ten practices across the UK have had health checks and LESs suspended but not income protected.

The February survey found:

  • 237 (11%) of 2,214 GP respondents have had services suspended without income protection;
  • A further 5% said the services had not been suspended although their practice is unable to deliver them
  • Less than half (44%) of GPs said the services were suspended with income protection for their practice.

BMA GP Committee chair Dr Richard Vautrey told Pulse the BMA is concerned that the guidance is being flouted in some local areas.

He said: ‘Our understanding is that most CCG LESs have been suspended and income protected. 

‘Where we have some concerns is local authorities who are not income protecting the enhanced services they commission – some local authorities have income protected those services but others have not.’

Dr Vautrey added that it is ‘unsatisfactory’ that practices are ‘not able to focus with confidence’ on other work but that the BMA is unable to negotiate directly with individual local authorities.

He said: ‘This is something that LMCs will have been trying to do and some have reached local agreements but others have found it much harder. That is a concern.

‘It’s unsatisfactory that some areas have not been able to secure income protection for work and are therefore not able to focus with confidence on the other work that needs to be done at this time because they’re still worried about the need to deliver services as required by the local authority.’

Setting out measures to mitigate GP workload in January, NHS England said CCGs should ‘immediately’ suspend LESs and protect ‘budgeted payment’ for them.

A letter said: ‘[Immediately] suspend any locally commissioned services, except where these are specifically in support of vaccination, or other Covid-related support to the local system, eg wherever they contribute to reducing hospital admissions or support hospital discharge. For example, suspension of reporting requirements relating to PMS key performance indicators. 

‘Budgeted payment against these services should be protected to allow capacity to be redeployed.’

A spokesperson for NHS England indicated that the guidance remains unchanged but did not confirm whether any action is being taken to ensure it is implemented.

In June, Pulse reported that practices in Essex were told they will have to catch up on targets for NHS Health Checks once the service is re-established post-pandemic, or they could face having payments clawed back.

It comes as the BMA and RCGP have called for an ‘urgent’ extension to GP Covid funding beyond the end of March, ahead of this week’s Budget announcement.

Meanwhile, the BMA has confirmed that QOF payments will not be protected beyond the end of March.