In a letter addressed to CCG leaders, obtained by GPonline, NHS England writes that the pilot scheme will be extended by three months, and clarifies the criteria that can exclude struggling practices from the scheme.
The peer support scheme, run by NHS England and the RCGP, is offered to ‘inadequate’ practices that are placed onto the CQC’s special measures programme.
The previously 12-month pilot, which was launched alongside the CQC’s overhauled inspection regime in October 2014, will now be extended until 31 December 2015.
Practices are expected to contribute half the costs required for the scheme, with the commissioner funding up to £5,000 in support.
The pilot is intended to help finalise what types of support best meet the needs of practices placed into special measures.
Other than in ‘exceptional circumstances’, all practices are offered access to the scheme during its pilot phase ‘to avoid introducing bias into the outcomes of the pilot’.
Under the 2014 framework, practices facing ‘contractual action’ were ineligible for the support package – but these rules have now been clarified by NHS England.
Dr David Geddes, head of primary care commissioning at NHS England, wrote in the letter that ‘it had become apparent’ that this rule ‘could be open to interpretation… given the degrees of "contractual action"’.
Clarified rules set out when support can be denied to practices. The letter states: ‘If there is any evidence of significant previous investment in the practice failing to result in improvement, commissioners may consider this as evidence that further investment is unlikely to be cost effective.’
It adds that any practice ‘where a notice of termination has been issued’ will also be ineligible to apply for support.
Each case ‘should be considered on its individual merits’ and ‘a remedial or breach notice’ alone should not prevent a practice being offered support from the pilot.
GP CQC support
GPC deputy chairman Dr Richard Vautrey said extending the pilot was a ‘sensible decision’.
‘It’s still early days to know the full benefit of the scheme,’ he said. ‘Fortunately, the number of cases that the scheme has been used for has been small, so I think we need more time to evaluate the impact it has on practices, and the benefits of the scheme itself.’
Denying practices access to the scheme should only take place in an ‘extreme scenario’, he warned.
‘I think the key thing is looking for evidence of redeemability. Is the situation that an individual practice finds itself in redeemable? There will be extreme cases where it is in the best interest of everyone to either change hands or close a practice.’