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GPs face funding shortfall as council threatens to stop paying for Health Checks mid-year

Exclusive GPs in one area could be forced to lay off staff or cut services after the local council threatened to stop paying them for the national NHS Health Checks programme mid-contract, local leaders have claimed.

Hertfordshire County Council told the LMC it wanted practices to stop providing Health Checks, meaning it would only pay practices for the activity carried out to 20 October – even though practices have taken on and trained extra staff specifically for the programme.

Local leaders have warned that the council is threatening to spin any protest as GPs jeopardising public health services because of their own self-interest.

But the GPC has said this amounted to ‘moral blackmail’, and that it showed the Government claims that NHS funding would not affect frontline services had been misleading.

The LMC has vowed to fight the council’s attempt to force practices to accept the deal.

Under the Health Checks scheme, practices are paid to call in patients aged between 40 and 74 years, who have not already been diagnosed with vascular disease, diabetes or renal disease, and carry out a vascular risk assessment.

As a public health enhanced service, it is now run by local authorities, who may commission GP practices or other providers such as pharmacies to run them. As part of this, Hertfordshire County Council had a deal with local GP practices to run the programme for 2015/16.

However, the council has now written to GP practices to request the change in their NHS Health Checks contract.

Dr Peter Graves, chair of Hertfordshire LMC, told Pulse: ‘The council have written to practices asking them to have a mid-year change of contract – they are only prepared for what’s been done to date.’

Dr Graves said the LMC was fighting the move, but the council has warned GPs about the consequence of protesting.

He said:  ‘The contract says it can’t be changed without both parties agreeing, so we are clearly going to fight this. They are threatening that this will go into the public arena as, “GPs potentially jeopardising public health services by putting their own personal interests first” , but they are not factoring in that this will jeopardise GP services.’

Dr Graves added: ‘GPs will plan their services based on a year’s income – so if they have taken staff on they either make those staff redundant, or they’re having to pay salaries that they are not going to be reimbursed for – so somewhere else in the system, something has to give.’

A spokesperson for Hertfordshire County Council said: ‘We are currently in discussions and it would be inappropriate to comment further. It is not our intention to terminate contracts.’

Dr Bob Morley, GPC negotiator on contracts and regulations, said the council’s action amounted to ‘moral blackmail’ and practices should take legal action if they end up carrying out unpaid work.

Dr Morley said: ‘It seems the Council is putting moral blackmail onto practices either not to do the work or do the work without any funding – either way it’s totally inappropriate.’

He added: ‘Quite simply, practices it they carry out the work must be paid under the contract, and if the local authority refuses then they may have to take legal action against it.’

The threat to cap funding of NHS Health Checks comes after the Government announced £200m cuts in public health funding earlier this year, which the Treasury insisted would come from projected budget surpluses and would not affect frontline services.

Dr Richard Vautrey, deputy chair of the GPC, said the move showed ‘how misleading the statements from the Treasury have been about not cutting NHS funding’.  

Pulse reported that an independent evaluation of the scheme found that it only reached only a fifth of its target population over the first four years.