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How are MPIG funding cuts affecting practices?

What is happening with MPIG?

The Government announced as part of the 2013/14 contract imposition that the minimum price income guarantee, which is used to top up the global sum to match their basic income levels, was to be phased out over seven years.

Which practices are most affected?

It soon became apparent that this would affect practices in the most deprived areas and rural areas, and NHS England said it identified 100 practices – later reduced to 98 – that were most at-risk of closure from the changes.

What support did NHS England offer?

Originally, the Government said it would be up to local area teams to provide funding, and hinted it would introduce new enhanced services to provide more funding for the most affected practices.

This support never materialised but after strong campaigning from Save Our Surgeries – led by the Jubilee Street Practice – NHS England offered a two-year delay in funding cuts to practices most at threat.

What are the eligibility criteria for the delay?

NHS England (London) sent practices letters spelling out the criteria, which NHS England said would be applied across the country.

The criteria included:

  • 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%;
  • 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.

How many practices were eligible?

NHS England has refused to divulge the figures on the number of practices eligible to Pulse or the GPC.

The Jubilee Street Practice, which led the campaigning, was found to be eligible.

However, Pulse revealed that NHS England has told practices that only 15 practices in total were eligible for the support, but this has yet to be confirmed.