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LES funding cuts push practices to the brink

Exclusive: Practices are reducing salaried GP sessions and preparing to shed staff after brutal cuts to local enhanced services funding in some areas have left practices floundering.

A Pulse investigation has revealed cuts in LES funding of nearly 50% in some areas this financial year as managers continue to tighten GP funding.

LMC leaders warn the cuts, after years of actual or near pay freezes, mean practices have been forced to take radical measures to survive.

Figures from 94 primary care organisations across the UK show LES budgets were slashed by 10% from 2010/11 to 2011/12 and have remained at a similar level this year, with a slight increase of 0.34% in 2012/13 compared with the previous year.

But the figures hide huge reductions in some areas with a 40% reduction in LES funding in 2012/13 by NHS Herefordshire, Heart of Birmingham Teaching PCT and NHS Coventry, compared with 2011/12, and reductions of 46% and 47% by NHS Middlesbrough and NHS Redcar and Cleveland this year.

Most PCOs – 50 in total – reduced their LES budgets this year and 40 increased funding overall. Four maintained their level of funding.

A Pulse survey in January revealed that a fifth of practices planned to lay off staff this year.

Dr Nigel Watson, chief executive of Wessex LMCs and a GP in the New Forest, said cuts were forcing GP partners to review their staffing levels.

He said: ‘Workload is increasing and when added to the cuts in LES funding, these factors mean practices are looking to make staff or salaried GPs redundant or failing to replace retired partners.'

Dr George Rae, chief executive of Newcastle and Tyneside LMC and a GP in Newcastle – where the LES budget was cut by a further 7% this year after a crippling 46% last year – said his practice was looking at restructuring. He said: ‘If the funding isn't there, it is difficult to provide the service. Partnerships are having to look at their structures – we are even doing that in our own partnership.'

Dr Mark Selman, a salaried GP in Totnes, Devon, and deputy chair of the GPC sessional GPs subcommittee, said he had seen salaried GP redundancies from PCT budget cuts in his area. ‘We have seen redundancies in the area. If things continue the way they are, we will see further reduced hours, reduced numbers of sessions and redundancies.'

Accountants also warned further funds could be stripped from general practice in 2013/14, because of changes that will require CCGs to use any qualified provider for most LESs. Bob Senior, director of medical services at accountancy firm RSM Tenon, said: ‘From 1 April 2013, with CCGs being responsible for LESs, we don't know how that will go.'