Officials from the London region are considering several options to address concerns that practices affected by MPIG funding cuts have had their losses miscalculated and been wrongly excluded from a financial support deal.
GP revealed exclusively last week that officials had admitted using incorrect data for two practices.
Two practices have said they have been wrongly excluded from the MPIG withdrawal support package offered by NHS England after protests. 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, which the BMA said were at risk of closure, were initially offered support.
GPs denied bailout
Questions over NHS England’s calculations could mean many more practices should have been classed as outliers or offered a bailout.
NHS England London admitted to GP that it used incorrect figures for two practices. Officials have told Albion Health Centre in Tower Hamlets it should have received a bailout, despite initially rejecting its claim.
Limehouse practice, in east London, also claims officials used incorrect data. Its case is under review.
Following the complaints, NHS England's chief executive Simon Steven intervened last month, promising that officials would examine the discrepancies.
Regional officials held an initial meeting with GPs and CCG members in Tower Hamlets last week.
Recalculation of losses
CCG board member and manager at Jubilee Street Practice, Virginia Patania, told GP that officials were considering options including a recalculation of losses for all practices.
She said NHS England was understood to be looking at options to address practices losses 'and the potential recalculation of MPIG losses nationally’.
The head of the primary care at NHS England South London, David Sturgeon, who was at the meeting, confirmed he was considering 'possible solutions' to address concerns over loss calculations, but that nothing had yet been agreed.
NHS England, he said, was ‘enacting’ the government’s decision to withdraw MPIG over seven years, suggesting it was not in a position to reverse those cuts.
But, he added: ‘There is a separate question around the accuracy of some of the modelling undertaken.
‘The modelling was to try and identify those practices that would be at greatest disadvantage [from] those changes. And there have been some questions raised around the accuracy of those figures. I haven't reached an opinion on that. I've been presented with some figures, and will look at those.’
He said: 'We had an exploratory meeting. We have been presented with some figures and we discussed possible solutions, which I have agreed to consider.'
NHS England London told GP last week that it had used incorrect list size data when calculating losses for two practices.
But practices complain that the modelling is flawed in several ways. Practices have told GP the assessment of their losses used incorrect figures for global sum, QOF, MPIG and seniority income.
Officials have said the modelling used the ‘best available data at the time’ to determine the relative losses as an ‘indicative’ exercise.
Practices have also disputed the method used to calculate an average loss from funding changes, which GPs say does not take account of the cumulative effect of the MPIG loss over the seven years.
Albion Health Centre 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.
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.