Exclusive: NHS England admits errors in MPIG loss calculations

A second London practice has spoken out after NHS England miscalculated its losses from the withdrawal of MPIG funding and excluded it from a financial support package for severely affected practices.

Save our Surgeries: campaigners helped win funding support
Save our Surgeries: campaigners helped win funding support

Albion Health Centre in Tower Hamlets, east London said NHS England had now backed down and agreed to include it in the bailout. But the practice has yet to reach an agreement on the level of support it should receive, because it believes NHS England still has not recognised the full extent of its losses.

Dr Spyridon Symniakou said that unless the practice received the full support it was entitled to it could become financially unviable.

NHS England has now admitted to GP that figures used to calculate MPIG losses at two London practices were wrong.

Incorrect financial data

Claims by several practices about incorrect figures and calculations have already caused NHS England chief executive Simon Stevens to intervene, promising that officials would examine the discrepancies.

The MPIG support package, agreed by NHS England following protests last year, offered practices a two-year reprieve on funding cuts through payments under section 96 of the 2006 NHS Act.

The package is available only to ‘outlier’ practices facing losses over £3 per patient per year in deprived areas. Just 17 of 98 identified outliers were initially offered support.

Questions over NHS England’s calculations could mean many more practices should have been classed as outliers or offered a bailout.

Practices demand support

Information obtained by GP using the Freedom of Information Act shows that a total of nine practices across England have so far challenged NHS England’s decision not to award them a bailout.

The London region said it still had two ongoing appeals, including one where it had backed down and offered the practice support, but it had yet to agree a final figure.

Of 11 offers made in London, just six have been finalised. Outside of London 10 offers of support have been agreed, but none has been signed.

Albion Health Centre serves the second most deprived part of Tower Hamlets, itself one of the most deprived boroughs in England.

The practice calculated, using NHS England’s method, losses of £3.34 per weighted patient in year one, and £5.24 in year two. When it factored in losses it believes NHS England’s method ignored, it calculated £6.80 per weighted patient lost in year one.

Loss calculation

NHS England London initially calculated the practice’s losses at as £1.89 per weighted patient.

After the practice insisted NHS England had miscalculated, the area team admitted the practice should qualify for a bailout. But the practice still disputes the calculations.

Dr Symniakou said the area team used incorrect figures in its analysis for list size, QOF, MPIG and seniority income.

NHS England told practices it used the ‘best available data at the time’ to determine the relative losses as an ‘indicative’ exercise.

‘The problem is that our losses are not indicative,' said Dr Symniakou, ‘and the threat to the services offered to our deprived population is real.'

Disputed losses

The practice disputed the method used to calculate an average loss from funding changes, which GPs believe does not take account of the cumulative effect of the MPIG loss over the seven years.

Albion practice complained that NHS England had assumed a list size increase without taking account of the additional costs associated with 1,000 more patients. The practice said NHS England had also miscalculated its deprivation score, which is used to help determine whether a practice qualifies for financial support.

Dr Symniakou said the problems with the calculations were ‘deeply worrying’ given the potential effect on ‘the quality of primary care services of hundreds if not thousands of practices serving the most vulnerable part of our population’.

Chairwoman of Tower Hamlets LMC Dr Jackie Applebee has said these practices were ‘the tip of the iceberg’ and NHS England and the government would have to find another solution to support practices facing heavy funding cuts.

Dr Symniakou encouraged practices to re examine any losses calculated by NHS England and said the east London Save Our Surgeries campaign could provide advice on doing so.

An NHS England London spokeswoman said: ‘While NHS England will not comment on individual cases, it’s important to note that we are applying a consistent approach by using the same model across  England.

‘In two cases the wrong weighted list size had been used. This has been rectified and the practices involved have been notified.

‘We have committed to review the issues raised by GMS practices in Tower Hamlets.’

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