Rural practice to close as PMS reviews hit GP funding

A remote rural practice has been forced to close ahead of a significant reduction in funding from the national PMS review.

Practice closed: PMS reviews to force Northumberland practice closure (Photo: iStock)
Practice closed: PMS reviews to force Northumberland practice closure (Photo: iStock)

Around 800 patients in rural Northumberland could be forced to travel up to 17 miles to find  a new GP after commissioners confirmed that Harbottle Surgery will close next Friday.

NHS England and Northumberland CCG, which jointly commission the service, said that no service would replace the practice or its two satellite clinics in neighbouring villages.

In a statement the partners blamed recruitment problems and a 'significant reduction' in funding from April 2016.

GP funding cuts

GPonline understands that funding reduction is the result of the national PMS review process to create equitable funding across contract types.

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'.

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.

GP contract switch

Earlier this month 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.

NHS England Cumbria and North East said it had identified £10.5m oif PMS premium funding for redistribution. Discussion ar5e ongoing with CCGs on how to reinvest it.

Harbottle Surgery GP Dr Rina Miah said: ‘Over the last few months we have tried really hard to recruit new GPs to work at Harbottle Surgery and its satellite clinics at Rothbury and Otterburn. Despite our very best efforts we have not been successful. ‘This, along with the practice’s new financial settlement which will see a significant reduction in our funding from April 2016, means that sadly we are not able to continue to provide a GP service from Harbottle Surgery.’

Local MP Anne-Marie Trevelyan (Con, Berwick-upon-Tweed) told the local press she was meeting NHS England officials to discuss a long-term plan.

Dr Craig Melrose, interim medical director for NHS England Cumbria and the North East, said: ‘We can confirm Dr Miah at Harbottle Surgery has had difficulty in providing access to services for patients within recent weeks and, unfortunately, these issues have not been resolved.

‘NHS England’s main priority is to ensure patients have access to high quality GP services therefore the practice will close from 28 August 2015, with no further service provided at Harbottle or the practice’s two branch surgeries at Rothbury and Otterburn. In light of this exceptional situation patients will need to register with a new practice to ensure continuity of care. We can provide reassurance that there are other practices in the surrounding area which have capacity to register new patients.

‘NHS England has worked closely with NHS Northumberland Clinical Commissioning Group to ensure arrangements are in place for patients to access alternative GP services and we are writing to patients to provide advice on how to register with another GP practice.

‘We are also working to identify any patients who need additional support during this process, to ensure a smooth and immediate transition to a new GP.’

Dr Melrose added: 'Locally negotiated GP contracts, known as PMS, have been reviewed over the last two years to ensure GPs are paid fairly and equitably for the services they provide.

'The purpose of these changes is to ensure that where GP practices are receiving extra funding, this is transparently linked to the quality of care they provide, and the needs of the local population.

'This means that in some cases money will be incrementally withdrawn from certain GP practices, but this would be over a number of years to allow practices to modify the services they provide if necessary. The changes apply to many GP practices who have successfully sought to work more efficiently. This is not a cut to primary care funding because money will be transferred to the local clinical commissioning group (CCG) to be re-invested into appropriate primary care services for their area.

'NHS England, Cumbria and the North East has sent a letter to all affected patients of Dr Miah to reassure them about what they can do to access alternative GP services, now she has taken the sudden decision not to continue with her contract.'

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