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MPIG-reliant practices have ‘no guarantee’ of protection, says NHS England



GP practices heavily reliant on MPIG will have ‘no guarantee’ of support from area teams, says new guidance from NHS England that reveals 98 practices in England face losses of up to £120 per patient.

NHS managers revealed that estimated losses for the 98 practices range from £3.01 to £119.27 per patient, with over half losing between £3 and £4 per patient. The names of the practices have been given to area teams, but not released publically.

NHS England had initially said area teams would protect the viability of outliers by commissioning extra services from them during the phase out, but yesterday managers said that there is ‘no guarantee that all practices on the list will receive support’.

The GPC said that they had told NHS England that the lack of a national process was ‘unacceptable’, but that it had secured an agreement for LMCs to be involved and that they should contact area teams ‘as soon as possible’.

In statement, NHS England said: ‘The list of outlier practices is only a guide for area teams. There is no guarantee that all practices on the list will receive support of other kinds.

‘Conversely, there may be practices outside the list of 98 “outliers’” for whom other commissioning arrangements may be appropriate. Area teams have been asked to look at each case on its merits.’

NHS England’s note further said the expectation that rural practices would be worst hit was wrong: ‘Rural practices make up less than 15% of the 98 “outliers”, whilst they make up 18% of all GMS practices in England. The majority of practices in both urban and rural areas will gain from the redistribution of MPIG resources.’

A GPC spokesperson said: ‘We have made it clear to NHS England that leaving these decisions to area teams rather than devising a suitable nationally directed process for area teams to adopt is unacceptable.

‘However, following our intervention, NHS England have now confirmed that they have encouraged area teams to work with LMCs to support practices that are adversely affected by the arrangements. We are expecting this to be reiterated in a formal message to area teams shortly.’

‘We will produce and publish more detailed guidance for LMCs as soon as possible. In the meantime, LMCs are encouraged to contact area teams and CCGs to request to meet with them as soon as possible, so that they can discuss ways in which adversely affected practices can be supported.

‘It is likely that some practices not identified as “outliers” may have equally strong cases for local support because of significant funding cuts. LMCs may also want to consider coordinating correspondence to local MPs on behalf of groups of affected practices.’