£50 per patient inequality in practice's global sums exclusive

Neighbouring practices can find global sum funding differences of as much as £50 per patient thanks to the MPIG, LMCs say.

Data obtained by GP show that GMS practices in four PCTs in the Cleveland LMC area earn between £51.78 and £93.00 per patient on their weighted list. The highest-paid PMS practice receives £109.18.

PMS practices had the highest income in the four PCTs - Langbaurgh, Middlesbrough, Hartlepool and North Tees. But both PMS and GMS practices showed similar variations in core funding. Some PMS practices earn 30 per cent less than the highest-earning GMS practices.

Cleveland LMC secretary Dr John Canning said the highest-paid PMS practice and the lowest-paid GMS practice were roughly comparable.

Londonwide LMCs and Bradford and North Yorkshire LMC confirmed that similar gaps existed in their areas.

‘The differences in funding are unfair. By agreeing to the MPIG, we froze the inequities that existed in 2004,' Dr Canning said. ‘Practices that were stuck in small premises and were unable to take on extra staff before the MPIG was calculated are stuck with that level of funding.'

He said patients at underfunded practices were not receiving fair funding for their care.

GPC leaders said the differences were being investigated by the GMS formula review group because they may be too great to be explained by the MPIG reinforcing historic inequalities alone.

Head of the BMA's health policy and economic research unit Jon Ford blamed the inequities on the effects of the MPIG, PMS growth funding and the Carr-Hill formula.

‘Funding per patient is not equitable and there is quite a wide range,' he said. ‘This was what formula-based funding was meant to rectify, but the MPIG cements so much of this, so historical factors come into play.'

However, he said the MPIG was vital to maintain existing provision until the DoH accepted a higher level of global sum funding. He said historical patterns of care were in place that people rely on, and removing the MPIG would destabilise practices.

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