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Darzi centre becomes first to agree pay cut

By Gareth Iacobucci

Exclusive: A Darzi centre in Suffolk has become the first in the country to agree to a reduction in the terms of its contract after the private firm running it accepted it was hugely overpaid for walk-in consultations.

The pioneering agreement with NHS managers will put pressure on PCTs across England to claw back money from GP-led health centres, as they draw up plans to make millions of pounds of efficiency savings.

It follows health minister Mike O'Brien's admission to Pulse last year that patients were using the centres as walk-in facilities rather than alternatives to GP practices, and that their contracts might need to be rewritten to reflect that.

Some GPs running the centres have also called for contracts to be rewritten, claiming it would be impossible for them to hit patient registration targets, but that they were popular as walk-in facilities.

The Practice plc, which holds APMS contracts with 12 PCTs across the country, has now agreed to a dramatic two-thirds reduction in its PCT payments for walk-in consultations, after conducting many more than expected. Its terms for registered patients remain the same.

The GP-led health centre in Haverhill registered just 286 patients between its opening on 3 June 2009 and February 2010, but saw 11,740 walk-in patients.

A spokesperson for NHS Suffolk said the decision to reduce contract terms was ‘agreed on both sides' since payments would otherwise have been much higher than anticipated.

The spokesperson said: ‘Walk-in activity reached a higher threshold sooner than anticipated at about 50 patients a day. At this point, we agreed with The Practice plc to move to the next threshold in the schedule, paying for higher levels of activity at a lower price per case.'

Peter Watts, chief executive of The Practice, said the company had been happy to operate on the less favourable terms, as it would be damaging to the private sector to be seen to be making huge profits from the NHS.

He said: ‘The contract in Suffolk was three times busier than priced by the trust. Now it's four times busier. We let it run for six months and then reduced our prices by two-thirds.

‘It doesn't benefit the private sector if we're making huge amounts from the NHS. If you've got a reputation of being hugely profitable, you won't tick the value-for-money box.'

Dr Fariba Fallahi, a GP at the centre, said its walk-in services were ‘more concerned with quality than quantity'.

‘If a patient needs 20 or 25 minutes to get good care, we give them that – it's only fair. I emphasise to patients how important continuity of care is. Even though they are seen here on a walk-in basis, we recommend they see their own GP.'

Pulse revealed last month GPs in Oxfordshire were engaged in a row with the PCT over the cost of consultations at its Darzi centre.

It follows Pulse's investigation last year showing centres across England averaged three times the funding per registered patient than GMS practices, prompting calls in our election manifesto to target the contracts for cost savings.

NHS Peterborough, which pays its Darzi centre £297.94 per walk-in session irrespective of patient numbers, was among those to say it would not revise its contract.

Dr Richard Vautrey, GPC deputy chair and a GP in Leeds, said: ‘This reflects how misguided the policy was. Darzi centres have effectively become walk-in centres, apart from a few where there was a genuine need.'

Dr Fariba Fallahi: centre will provide walk-in consultations of up to 25 minutes where needed by patients Dr Fariba Fallahi: centre will provide walk-in consultations of up to 25 minutes where needed by patients Pulse Manifesto for General Practice

Point two of Pulse's 'Manifesto for General Practice' is to 'Cut waste on Darzi contracts and managers, but protect services'.

To find out more about the Manifesto for General Practice, please click here.