Proposals as they stand would have a ‘huge impact on practices’ and should be ‘fully modelled’ before implementation, the BMA warned in response to a DH consultation on GMS contract changes.
The BMA response acknowledges that practices currently receive ‘widely differing core funding per weighted patient’.
It says GPs accept the need to reduce this variation, but that the reasons for historical differences in pay are complex, and the change must happen slowly so that it does not ‘radically destabilise patient services’.
A BMA poll on changes to the contract found that 85% of GPs believe scrapping MPIG will have a negative impact on staffing, services and income.
The BMA says that plans to reduce correction factor payments – which top up core funding under the MPIG deal – by one seventh each year for seven years from 2014 do not ‘allow for the increases in global sum resulting from recycling of the correction factor money, annual uplifts to global sum and redistributed PMS funding’.
It warns: ‘Erosion of MPIG was only part of the proposals drawn up between NHS Employers and GPC for reducing variability in practice funding.
‘In the absence of proper redistribution of PMS funding, correction factor recycling and annual uplifts, there will really be no equalisation of resources across practices.
‘This exercise, as proposed, will generate a huge amount of bad feeling amongst affected practices, especially as MPIG was promised in perpetuity, and will destabilise many.’
The proposals fail to make any commitment to ‘give special consideration’ to practices that may, for legitimate reasons, ‘receive and require greater per capita funding than global sum payments can deliver’.
The BMA response warns: ‘The GPC wants to see a commitment to giving outliers proper consideration and to excluding from the process those who need higher funding for legitimate reasons.
‘We urge the DH to go back to the draft proposals developed between NHS Employers and the GPC. Implementing these plans before full modelling has been done may lead to serious unintended consequences for patient services.’
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