Five GP practices could close after PMS review funding cut

Five practices serving more than 11,000 patients in Brighton could close after a provider organisation gave notice to terminate its contract following a review of the PMS contract funding.

NHS England officials have written to patients reassuring them that work is underway to secure alternative provision.

In a statement, primary care provider The Practice Group said: ‘It is with great regret and sadness that we have given NHS England notice to terminate the joint PMS contract in respect of the five Brighton based GP surgeries where we currently deliver primary care services. These surgeries operate under a sole contract and therefore The Practice Group has no option [other than] to exit all five of the following surgeries.’

The group said the practices faced a ‘significant reduction in funding’ under the PMS contract reviews which meant ‘it will be impossible to run these surgeries under present contractual arrangements’.

GP services at risk

The five practices, the group said, serve some of the most deprived communities in Brighton as well as vulnerable homeless people.

The group said it would work with the NHS to ensure a smooth handover of patient care.

A spokesperson for NHS England South said: ‘Our priority is to ensure all affected patients have ongoing access to local GP services following notice given by The Practice Group that they wish to stop providing services at five local surgeries in Brighton and Hove.  

‘We have written to patients to reassure them that we are working to secure alternative arrangements for their care and are continuing to work with NHS Brighton and Hove CCG to identify the available options.

‘All patient feedback will be taken into account in reaching a final decision about how to guarantee their future care and we will update patients about this as soon as we can.’

Last week three GP partners at an Essex practice rated outstanding by the CQC gave notice after a PMS review resulted in a ‘significant reduction in funding’.

CQC review

The partners at Sutherland Lodge practice in Chelmsford said in a letter to patients: ‘This loss would mean a severe cut in the services we have worked so hard over the years to develop. We feel very strongly that after the inevitable rise in the doctor to patient ratio, which will move from 1:1890 to 1:4000 we will not be able to continue to provide the current level of services nor be comfortable in providing the significantly reduced level of service that the new contract would require.’

NHS England said it was working with the CCG and LMC to identify a new provider.

GP leaders have warned of a ‘collapse’ of GP services in some areas as a result of the national PMS review, part of NHS England and the government’s equitable funding policy.

GPC executive lead on PMS Dr Brian Balmer told GPonline in August he had warned NHS England they face ‘practice collapse’ or a ‘very public’ loss of services when the funding cuts begin to bite.

NHS England identified in 2014 £325m of 'premium' funding that PMS practices receive above GMS equivalent, including £258m which 'may be associated with enhanced services or populations with special needs, but is not defined'.

PMS premium funding

After the redistribution of MPIG top-ups the funding 'premium' received by PMS practices will drop to £235m.

Local commissioners have until March 2016 to conclude reviews of local PMS contracts and decide how far to redeploy any premium funding. Reinvestment must take place over a minimum four-year period from 2015/16.

In August GPonline exclusively revealed the extent of premium funding local areas teams expect to redistribute. Information obtained by freedom of information request showed that nationally a fifth of PMS practices had reverted back to GMS since the national review process was imposed in 2013.

Brighton and Hove CCG chairman Dr Xavier Nalletamby said: 'We are actively engaging with all affected and neighbouring GP practices and with NHS England to support a calm, well thought through and fair process for local patients and general practice.

'We hope the outcome will strengthen and improve the quality of general practice in the city in the longer term, and will be doing everything we can in the short term to help prevent practices from being de-stabilised or overwhelmed.'

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