This funding, which delivers close to half of the core pay some practices receive, will be ‘reinvested into global sum payments’, a DH letter setting out proposed changes to the GP contract reveals.
Most practices now receive less than 10% of core pay from MPIG correction factor payments, but removing the top-ups could force up to 5% of practices in parts of the UK out of business, GP leaders fear.
From April 2013, the NHS Commissioning Board (NHSCB) will also begin discussions with the 35% to 40% of GP practices on locally negotiated PMS contracts to ‘agree the basis for implementing similar actions’.
The PMS overhaul will aim to ‘achieve equitable and fair core funding between GMS and PMS contractors on the basis of a standard weighted capitation funding formula’.
But little further detail has been revealed about how this will work in practice, or the impact it will have on practices.
The DH has made clear that since the GPC chose not to accept the 1.5% uplift offered as part of a negotiated settlement on the GP contract, it will now consider any recommendation from the Doctors and Dentists Review Body (DDRB) on pay.
The DDRB has not confirmed whether it intends to make a recommendation on GP contract funding, but is expected to make recommendations on pay in February 2013.
If the government opts to give GPs a funding rise, it will not all be applied to QOF payments. Part of any increase will be distributed through global sums in a way that prioritises ‘narrowing the funding gap between practices while providing some uplift to all practices’.
‘We will make final decisions on the relative investment between practices in the light of the DDRB’s recommendations,’ the DH letter says.
GPC member and Wessex LMCs chief executive Dr Nigel Watson told GP that 15 to 20 of the 400 practices represented by Wessex LMCs would be severely affected by the cuts and could no longer be viable.
'Some practices receive correction factors worth £20,000 to £30,000, but we have some practices with 25% to 30% of their income from correction factors. If you take that out, they would not be viable,' he said.
He said practices had driven up their efficiency in recent years to cope with lower funding, but would lose £50,000 on average if MPIG disappeared. He said: 'If you took 50k out of a practice, they either have to make staff redundant or take another hit on income. Many are feeling the best way forward may be to hand the keys back and work as a locum rather than keep running a business that is becoming less and less viable.'