'Automatic' swine flu pay cuts feared

Threatening letter withdrawn after GPC complaint, but GP income still at risk.

Dr Fay Wilson: PCTs need practices to be part of their flu response
Dr Fay Wilson: PCTs need practices to be part of their flu response

Practices forced to reduce or suspend essential, additional or directed enhanced services in the swine flu pandemic face 'automatic' funding cuts, advice sent to PCTs says.

The guidance, distributed by NHS Primary Care Commissioning, has been withdrawn by the DoH after GPC complaints about its 'threatening' tone.

But GPC chairman Dr Laurence Buckman admitted that talks with the DoH are still ongoing over whether practices overloaded with swine flu can suspend services without being hit financially.

The guidance says GP practices should talk to their PCT about services they may be unable to deliver, and PCTs 'have discretion' to offset losses.

But it adds that 'certain financial consequences would be automatic'. It explains that if an additional service ceases, 'a deduction must be made', a directed enhanced service 'cannot be paid for if it is not delivered' and 'childhood immunisation payments cannot be made if targets are not met'.

Dr Buckman said the GPC and the DoH were currently negotiating a solution so that it 'never reaches that stage'.

But he warned: 'The thing to do is not to withdraw services without entering into discussions with your PCT - you will have funding cut, it is in your contract.'

Dr Buckman added: 'We are negotiating to have the letters written up properly and not worded in a way that will scare people.

'The letter is amazingly unfortunately phrased. I can see why any practice would look at it and think "what on earth is this?".'

RCGP pandemic flu lead Dr Maureen Baker said a national principle must be agreed, which could then be applied locally.

'We have always advised that there need to be mechanisms in place so there is not some kind of penalty,' she said.

GPC member Dr Fay Wilson said no PCT should penalise practices wishing to help out with their flu response. 'The forecast is that the second wave will be more severe and they have been right so far. I do not think any PCT is dim enough to make it difficult for a practice to be part of its flu response.'


  • GPs must notify PCTs of planned reductions in service during the pandemic and await reply.
  • Certain financial consequences will be 'automatic' should services be reduced/suspended.
  • PCTs have discretion to enter into local agreements to offset losses or offer temporary support to practices.
  • Practices suspending/reducing services without PCT agreement may be subject to the full range of penalties available.

Source: NHS Primary Care Commissioning

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