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Support services for GPs to be cut as part of cost-saving initiative

GPs are set to lose a range of support services provided by NHS managers, including the collection of medical records and certain payment services, under a cost-saving programme.

NHS England is looking to save £40m from its primary care support services budget, and has announced a series of services that it will no longer centrally fund.

The funding for services such as checks on practice lists, informing patients when a practice closes and mailing health check invitations are being reconsidered.

GP leaders have condemned any further erosion of GP funding after the profession was hit a 0.28% pay uplift next year and an increase to pensions contributions.

The cuts to primary care support services follows a series of problems with NHS England payment systems, which have left some practices in severe financial difficulties for months.

The document on support services divides them into ‘core’ and ‘non-core’ functions. NHS England pledged to retain all core functions, including ‘payments of practitioners on the Exeter system’ and forwarding records following patient registration.

However, it said that for ‘non-core’ services, ‘provider arrangements need to be identified for the future or, in some cases, they will stop’. It added: ‘A project is underway to decide the future arrangements.’

The non-core services include:

  • ‘GP courier services (charging practices for the collection of records as per the regulations)’;
  • ‘payments that are the responsibility of other bodies, including local authority / CCG-responsible payments (eg collaborative fees)’;
  • ‘checks to ensure that the population database is correct’; and
  • ‘administrative activities when a GP practice closes such as informing patients’.

Dr Robert Morley, executive secretary of Birmingham LMC and GPC member, said that these were the latest in a range of cost-cutting measures being deployed by NHS England.

He said: ‘Some of these things, area teams have provided this stuff historically anyway, and others haven’t provided them. Clearly – as expected – the whole idea of the consultation is to level services down to get away with as little as they can on behalf of practices.’

‘It’s going to end up as more work for practices, greater expense for practices and a poorer and less safe service for patients inevitably. Practices are stretched as much as they can be at the moment, and they’re going to have to do even more administrative work here that historically the NHS has provided for them.’

Dr Morley added: ‘It’s yet more burden on general practice when they’re struggling to keep their heads above water as it is.’

GPC chair Dr Chaand Nagpaul told Pulse that it was crucial that GPs were consulted before any decision was made, as even minor cuts could impact on frontline care.

Dr Nagpaul said: ‘It is absolutely vital that NHS England discuss these proposals with local medical committees and GPC, given that removing prioritisation of some functions could have an impact on GP practices and their delivery of care, as well as the administrative support to provide services.

‘So  given that, I think it’s important that – before any decisions are taken – there is proper dialogue with GPC and, in particular, with LMCs who will be best placed to input into the impact of removing the prioritisation of some elements of support.’

A spokesperson for NHS England: ‘The decision about core and non-core services was taken earlier this year. NHS England would like the delivery of non-core services to continue but these will not be funded centrally.’

‘NHS England is currently working to identify how these service will be provided and funded in future, and will continue to engage national and local stakeholders, including GP representatives and staff.’