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Practices losing more than £3 per patient to be eligible for funding support



NHS managers have outlined a string of strict criteria for practices to receive funding support as a result of changes to MPIG following the decision to delay cuts for two years.

NHS England (London) said today that only practices that are losing more than £3 per patient as a result of the changes to MPIG will be eligible for the two-year reprieve from the funding cuts announced this week, while practices where partners earn more than £106,000 will not qualify for support.  

Other criteria include no contract breaches for any reason issued since 1 April 2013, and expenses must be more than 63% of turnover.

The decision to offer a reprieve to MPIG practices came after campaigning from GPs and patients in affected areas, and followed Pulse launching its Stop Practice Closures campaign.

A letter from NHS England’s London head of primary care commissioning Neil Roberts, addressed to London LMC leaders, said that the measure was pending the outcome of the review of the Carr-Hill funding formula to better account for levels of deprivation.

Terms to be eligible to apply were outlined as:

·         a reduction in GMS global sum funding greater than £3 per weighted patient in 2014/15;

·         no doctor in the practice declaring pensionable earnings in excess of £106,100 per annum, with a pro rata adjustment for part time GPs (the England average for 2011/12);

·         practice expenses evidenced as greater than 63 per cent;

·         no contract breaches for any reason issued since 1 April 2013;

·         fewer than half of contract holders having “live” cases with NHS England performer machinery or GMC, including the Interim Orders Panel

·         fewer than five outliers on the GP High Level Indicators (GPHLIs) on the current system;

·         evidenced extenuating circumstances within the practice population related to patient demographics that impact on practice workload – defined as an IMD score of 35 or higher for the practice population.

The letter said: ‘[P]ending the outcome of the review of the national funding formula, the London region of NHS England, in discussion with NHS England’s national primary care team, proposes to offer financial support to those practices that are losing more than £3 per weighted head of patient population from GMS funding changes in 2014/15 and where the current funding formula may not provide sufficient sensitivity to local patient needs.’

The letter said the interim solution, which will apply for 2014/15 and 2015/16, had been worked out based on meetings with affected practices.

It continued: ‘Both in London and in other parts of the country, one of the main themes to arise from these discussions has been whether, in some specific cases, the Carr-Hill formula may not sufficiently reflect relative practice workload because of specific demographic factors, particularly in relation to levels of deprivation. Work is currently underway nationally to review the Carr-Hill formula, specifically with a view to giving greater weight to deprivation factors.’

Mr Roberts said he would have posted a letter to each practice set to lose more than £3 per patient by the close of Tuesday of this week (12 August) and practices must sign an agreement with the area team by 30 September to remain eligible for the funding. He also said the identity of the practices would remain ‘not in the public domain’.