Exclusive - Consortia pay levy to slash GP income

At least 15% of practice income should be top-sliced to fund quality premium payments for GP consortia, according to a leading Conservative GP.

Dr James Kingsland: 'Historically, we have invested in failure. So more money should go to successful practices' (Photograph: R Stratton)

The move could trigger a huge redistribution of GP funding and GP leaders warn it could create perverse incentives to cut referrals and prescribing.

But a leading GP adviser to the DoH backed the move as a way to force out poor practices, warning that the NHS had 'invested in failure' for too long.

The White Paper Liberating the NHS sets out plans for part of practice income to be tied to consortia's outcomes and financial management.

Consortia would be free to decide 'how best to apportion' this between member practices, the White Paper says.

Conservative Medical Society chairman Dr Paul Charlson said the figure should be large enough to act as an incentive to practices. He said that assuming QOF payments came down, a 15% levy for the quality premium would mean 30% of GP pay was performance related.

'It is not unreasonable. We would be disingenuous if we said that all GPs performed as well as others because that's not the case,' said Dr Charlson.

Dr Charlson said consortia could allocate poor practices a lower share of the quality premium. 'Some people will be worse off because they are not working as hard. It's about time: bring it on,' he said.

The DoH's GP commissioning national clinical lead for England Dr James Kingsland said he hoped top slicing would kill off poorly performing practices.

Quality premiums should reward successful practices more, he said. 'Historically, we have invested in failure in the NHS. So more money should go to successful practices.'

Dr Kingsland said that if poor practices were forced to close then so be it. 'If the unsuccessful bits start to shrink then I question their long-term viability, ' he said.

But GPC deputy chairman Dr Richard Vautrey warned a large top-slice could create perverse incentives. 'If it is a sizeable portion - and 15% would be a sizeable portion - patients may believe the doctor is only recommending a particular treatment because of a direct link to financing the practice,' he said.

Editor's blog: Is 15% of GP income too high for quality premiums to consortia?

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in


Just published

BMA Scotland GP committee chair Dr Andrew Buist

'Disappointing' uplift falls short of 6% pay rise promised to GPs in Scotland

A 'disappointing' uplift to contract funding worth £60.4m in 2023/24 will not deliver...

Person selecting medicine in a dispensary

Dispensing GPs demand funding overhaul to ensure services remain viable

Dispensing doctors have demanded improved representation in GP contract negotiations,...

GP consultation room

GPs seeing cases of malnutrition and rickets as cost-of-living crisis hits patient health

Three quarters of GPs are seeing a rise in patients with problems linked to the cost-of-living...

Female GP listening to a patient

What GPs need to know about changes to Good Medical Practice

Dr Udvitha Nandasoma, the MDU’s head of advisory services, explains what GPs need...

Dr Caroline Fryar

Viewpoint: Doctors should be given protected time to digest Good Medical Practice

There's a lot for doctors to digest in the GMC's Good Medical Practice update before...

MIMS Learning Clinical Update podcast

MIMS Learning Clinical Update podcast explores the ‘defining issue of our age’

The latest episode of the MIMS Learning Clinical Update podcast features an interview...