Exclusive GP partners in some areas are in such financial difficulty that they have been unable to pay themselves for several months as the GPC warns that managers must act to avert a ‘serious crisis’ in general practice.
Pulse has learnt that LMCs are warning they have heard of several examples of GP partners not being able to take out drawings for months because of payment problems and swings in practice income, warning that the situation is unlikely to improve ‘anytime soon’.
The GPC warned they are hearing of increasing examples of practices ‘facing financial meltdown’ and has started an information-gathering exercise on the possibility of practices having to close.
The news comes as practices prepare for further disruption to their finances, with MPIG payments slashed, the review of all ‘premium’ funding going to PMS practices and local enhanced services being put out for competition.
GPC member for Manchester, Salford, Trafford and Stockport, Dr John Hughes, said there was a ‘potentially very serious situation’ developing where multiple practices could become financially unviable.
Dr Hughes said: ‘We’re getting a lot of information about practices where partners haven’t made any drawings for two to three months. Somehow they’ve had to put money into the practice to be able to pay the practice staff.’
He added: ‘It is for multiple reasons – delayed payments due to chaos of outsourced and multisource payments where previously done by the PCT finance department, changes in timing of payments, changes in some areas which previously had advance of QOF predicted payment, loss of LESs and many other factors.
‘And all this is before MPIG or PMS changes come in, with many practices struggling with income and little prospect of improvement in near future.’
Dr Hughes said the GPC was investigating the possibility of practices closing: ‘GPC is collecting and collating info from all LMCs as this seems to be an England-wide problem, and could potentially result in practices becoming financially unviable and having to close, with all the implications that carries.’
Dr Chris Hewitt, medical executive director at Leicester, Leicestershire and Rutland LMC, said he was planning a local ‘crisis’ meeting to discuss how to advise practices at risk.
He said: ‘They can’t pay their bills, they are having to put in money, they are overdrawing [from the bank] and having to let staff go. I have been calling for a crisis meeting with the LMC, CCG and area team. Normally I’d say don’t overreact and take a portion of your drawings, however I think this is genuine, some people are really struggling at the minute.’
GPC negotiator Dr Beth McCarron-Nash said: ‘What we are hearing from several LMCs, across several areas, is of varying degrees of financial hardship and anecdotal stories from some areas where partners have actually not been able to take drawings for several months, because of significant financial difficulty.’
‘As this is being reported from various LMCs this is obviously a huge problem, certainly considering the financial situation and also the change in the way practices are actually gathering income, such as the changes to enhanced services. This is all putting financial strain on and adding difficulty for practices.’
GPC deputy chair Dr Richard Vautrey said: ‘We are concerned by the increasing reports of practices and GPs in financial problems caused through no fault of their own. Our fear is that this is only going to get worse as NHS England pushes ahead with cuts to essential correction factor payments and slashes PMS funding. This alongside cuts to enhanced services, dramatically rising expenses and the interference of DH to annual DDRB awards means increasing numbers of practices will question their viability. This is all set in the context of general practice now only receiving 7.4% of NHS funding, which is not sustainable even in the short term.’
‘As we collect more and more specific examples of practices facing financial meltdown we will be using these as reasons why both NHS England and DH need to invest in general practice as a whole to avert a serious crisis.’
It comes as the BMA has warned that margins are increasingly being squeezed in GP practices as the proportion of funding that went towards paying expenses rose from 59% to 62% since 2008/09.
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