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MPIG-reliant practices left out in cold as NHS England fails to provide promised support

Exclusive GPs face little of the promised support to protect them from the withdrawal of the minimum practice income guarantee after not a single local area team committed any additional funding, despite assurances by a health minister only last week, Pulse can reveal.

Area teams across the country have not, as of yet, committed to adding extra funding support or commissioning additional services from any practice affected by the swingeing cuts, NHS England has confirmed, despite warnings that many face potential closure.

This is also despite initial assurances from NHS England that ‘outlier’ practices would be protected, and comes in the same week as health minister Daniel Poulter said in a Westminster Hall debate regarding the MPIG withdrawal that NHS England is ‘supporting practices as they phase in the changes to the minimum practice income guarantee and to QOF payments’.

The GPC branded the lack of support as ‘appalling’ and Londonwide LMCs said it has contacted NHS England to demand it provides temporary funding.

The Department of Health has admitted that over 200 practices in England will lose more than £2 per patient from the MPIG withdrawal. MPIG-reliant practices such as the Jubilee Street Practice in Tower Hamlets in east London, and the Rowhedge and University of Essex Medical Practice in Colchester, are already considering measures such as reducing appointments, or simply closing down.

But Pulse has learnt that no area team has yet committed any funds to help the practices.

A spokesperson for NHS England area teams in London and the south of England told Pulse that while they have not committed to any additional funding, they were ‘discussing with their individual practices the impact of the phasing out of MPIG’.

Meanwhile, a national spokesperson for NHS England confirmed that this was the case also in the north, Midlands and east of England but said that focusing on ‘that one area’ of protecting practices does not ‘give the actual full picture’.

The spokesperson said: ‘NHS England’s area teams are working with the practices most significantly affected to identify if there are special circumstances that would justify making other payments to them, for instance to reflect any factors that are not adequately captured by the normal funding formula, or if any services that the practice provides would more appropriately be commissioned by clinical commissioning groups (CCGs).

‘All practices are receiving an increased global sum this year and all practices know that this will increase year on as a result of the MPIG redistribution. Some practices deliver (or intend to deliver) additional services that tap into other funding outside the GMS contract which funded by other streams such as CCG funding.’

Dr Poulter said last week: ‘[T]he offer is there from NHS England to engage with area teams to see what more support can be provided. It is keen to ensure that if particular practices believe they are disadvantaged, the teams will do what they can to work with the practices to mitigate that.’

But Londonwide LMCs medical director Dr Tony Grewal said: ‘NHSE (London) have explicitly stated that no money is available to support practices severely affected by the withdrawing of MPIG payments. They have offered organisational support to practices from within existing resources.’

He added that the LMCs in London have requested they reconsider and add temporary funding to support practices.

‘Londonwide have made a number of other suggestions for their consideration, including temporary bridging payments to practices under section 96 of the statement of financial entitlements. We are waiting for their response.’

GPC deputy chair Dr Richard Vautrey said: ‘It is appalling that despite the rhetoric NHS England are failing to support practices in a crisis created by NHS England’s actions. Patients will suffer as practices cut staff and services or even close altogether’.

He added that MPIG cuts are ‘only the tip of the iceberg’, with this year’s review of all PMS contracts set to put an even larger chunk of general practice funding at risk.

He said: ‘Three times as much funding is at risk of being removed from PMS practices from next year. It is vital that this money is invested in practice baselines to support essential work being done by practices.’

On a visit to the Jubilee Street practice earlier this week, shadow health secretary Andy Burnham told Pulse that it was ‘unacceptable’ for GP practices to be ‘destabilised’ in this way.

In Wales, the Government and GPC are currently working on a new DES which would support the viability of remote rural practices when they lose their MPIG.