Viewpoint: Dr Chaand Nagpaul: We cannot afford for under-threat MPIG practices to close

The government's decision to begin the phase out of the MPIG from this April is casting a huge shadow over the future of hundreds of practices across England, writes GPC chairman Dr Chaand Nagpaul.

Dr Nagpaul: 'We simply cannot afford for any of these practices to reduce vital services or close.'
Dr Nagpaul: 'We simply cannot afford for any of these practices to reduce vital services or close.'

NHS England has confirmed that 98 practices will be seriously affected while hundreds of others will see significant drops in their core funding. One GP practice which has already told the BMA it expects its funding to drop by at least a third, a huge cut that comes at a time when workload pressures are continuing to rise and overall practice incomes are sliding.

In some cases, those affected will be smaller, rural practices that provide vital care to isolated communities spanning large geographical distances.

One GP in the north west of England who could be affected by these changes is Dr Katharina Frey, who runs a practice in South Cumbria that cares for just under 1,000 patients and provides an incredibly important service for her local community.

The practice is under financial pressure to the extent that it is having to think very carefully about how it will replace senior staff. If it were to lose the support of MPIG it would see a reduction in a third of its current core funding. Kathy said she simply doesn’t know how she will cope with this additional financial blow. Her story reflects the anxious concerns that many grassroots GPs are reporting to the BMA.

Unfortunately, NHS England’s approach to this issue has added another self-inflicted problem to those facing the practices affected. Practices were informed at a very late stage of their funding plight. Although we were given assurances that outlying practices would be offered appropriate protection, ministers have not come up with a national plan to solve this deepening crisis or confirmed where these practices are, instead opting to shunt this issue on to local area teams.

There is little evidence that these teams have managed to come up with a solution, which is not surprising given the pressures they are facing.

We simply cannot afford for any of these practices to reduce vital services or close, especially those in rural areas where the end of a local practice will have a devastating impact on the patients.

We need to ensure there is a national plan that guarantees these services and that all GP surgeries will continue to provide the best accessible service to our patients. It is impossible for this change to go ahead without a framework on how these GP practices should be supported.

Ministers must act urgently to resolve this problem as these funding reductions are just a few weeks away from being implemented. A huge loss in funding must not have a detrimental impact on the care GPs give to their patients, many of which are vulnerable, elderly and alone.

A service that is robust and reliable must still always be at the forefront of any government change in order for us to be able to provide the best possible care to our patients.

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