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GP practices lose ‘hundreds of thousands’ as federation goes bankrupt



Exclusive GP practices may lose ‘hundreds of thousands’ in money invested in a local GP federation which is going into liquidation, Pulse has learned.

The decision to liquidate the Bedfordshire-based federation, which it put down to national recruitment problems as well as internal management issues, will lead to the closure of a local GP practice with 6,000 patients.

The federation also provides a range of community services, including musculoskeletal, anticoagulation, phlebotomy, ultrasound and vasectomy, which are now facing an uncertain future.

In all, 54 Bedfordshire practices had invested at least 65p per patient in provider company Horizon Health Choices Ltd, GPs working for member practices told Pulse.

This amounted to a total of around £284,700, according to their calculations, or just over £5,000 per GP practice, depending on size.

It was first set up in 2006, when 24 Bedford practices joined up to bid for and provide community contracts, expanding to 54 practices in 2014.

Like many other GP federations, Horizon was launched in response to Government encouragement for GPs to work at scale, members said – which NHS England has since made a national priority with the GP Forward View and the new MCP contract for groups of practices with at least 30,000 patients.

The news comes as GP practices around the country are already working together at scale in similar organisations, or are being encouraged to do so under Government plans outlined in the GP Forward View and the new multispeciality community provider (MCP) contract for groups of practices with at least 30,000 patients.

The provider company’s leadership declined to comment on the figures provided but said in a statement: ‘The company has faced some difficult challenges over recent months.

‘Despite making every effort to stabilise the organisation, a national shortage of GPs, particularly in Bedford, has required significant investment in locum doctors.

‘The financial impact of this has forced the shareholders to pass a resolution to move towards liquidation.’

The company added that this ‘means that Horizon will no longer be providing the caretaker role for both Lansdowne Road Surgery and the Village Medical Centre in Great Denham’.

NHS England said Lansdowne Road Surgery – whose partners resigned the contract at the beginning of this year due to recruitment problems –  is closing as a result, with 6,000 patients set to be dispersed to neighbouring practices. It said another provider will take over the running of the 7,000-patient Village Medical Centre.

In an invitation to an extraordinary general meeting last month, Horizon chair Dr Sarah Hood said problems also included a ‘problematic’ contract to provide musculoskeletal services as well as issues with board resignations and financial management.

She said: ‘As you can now see sadly the reality of the financial position of Horizon and the profitability of some if its services is now highly questionable, with performance management and activity monitoring being side-lined in preference to growing the business.’

A GP at one of Horizon’s member practice, who wished to remain anonymous, said: ‘My partners and I had invested several thousand pounds in this organisation in share terms and have lost the lot.

‘The precarious funding of all aspects of primary health care makes all such ventures a huge risk and I would never get involved again at such large scale.’

A GP at another member practice, who also requested anonymity, said: ‘Horizon Health Choices limited was a provider company set up by the GP federation of all Bedfordshire practices. All practices bought shares in the business, at 65p per patient. Our own practice has therefore lost about £3,400.’

Earlier this year, Pulse revealed how practices in Doncaster had been stuck with £20,000 losses after their GP federation providing six APMS contracts, Danum Medical Services Ltd, went bust.

One Doncaster practice warned at the time that other GPs needed to be aware of the liabilities they were incurring when signing up to work together at scale.

Bedfordshire and Hertfordshire LMCs chief executive Dr Peter Graves said GP practices should use collaboration as a means to achieve better resilience and financial stability for member practices, and that ‘only then should federations start looking at business outside the core GMS contract’.

Locality director for the Central Midlands Dominic Cox said NHS England is ‘acutely aware of the pressures on GPs and their services in Bedfordshire’ and is ‘targeting local investment’ to relieve practices.