Exclusive: NHS officials declare 20% of GP practices 'vulnerable' in parts of England

More than 20% of GP practices in parts of England have been identified as 'vulnerable' by NHS officials administering an emergency support fund.

Figures obtained by GPonline using the freedom of information act revealed that 811 practices, over 10% of the total number in England, were identified by local NHS England teams as qualifying for support under a £10m ‘vulnerable practices’ fund pilot scheme (see table).

The revelation adds further weight to GP leaders' warnings over the growing crisis in the service. A BMA survey of 3,000 practices published earlier today found 10% believe they are financially unsustainable.

The GPC warned that the 811 practices identified by NHS England were likely to be the ‘tip of the iceberg’. The figures obtained by GPonline showed the £10m fund was not enough to make a difference, GPC deputy chairman Dr Richard Vautrey said.

GP practices at risk

Commissioners used criteria including CQC reports, GP performance, patients per doctor, list closure applications, as well as intelligence from CCG and LMCs, to identify the most vulnerable practice in their areas.

A breakdown of vulnerable practices by NHS England subregion reveals the North Midlands has the highest number of vulnerable practices with 115, equal to 22% of the total number of practices listed in that area in 2014/15.

The London region identified 222 vulnerable practices, more than 15% of the total, while the South Central subregion found 66, around 15% (see table).

The vulnerable practices fund is drawn from the £1bn primary care transformation fund - previously called the infrastructure fund - announced in the 2014 autumn statement. Announcing the fund last year, health secretary Jeremy Hunt told GPs: ‘I have today also asked NHS England to work with NHS Clinical Commissioners to develop a £10m programme of support for struggling practices. This will include advice and turnaround support for the practice itself and help for the practice to work with others to change its business model.’

Official NHS England figures published in December show that the total funding allocated to local teams is £9.325m. The 811 practices identified would get around £11,500 each on average, ranging from around £6,800 in London to £35,500 in Wessex (see table).

Local support

Since identifying the vulnerable practices commissioners are now working with GPs to develop a local support offer. Practices will be required to match the funding on a 50/50 basis to qualify for support.

NHS England said that discussions with CCGs on prioritisation were ongoing in some areas, meaning that some of the figures released could change.

Dr Vautrey said: ‘With more than 10% of practices already identified as part of this process, it's clear that the £10m fund will be nowhere near enough to make the significant difference that these practices both need and want to receive.

‘It's likely that this is also the tip of the iceberg and many other practices will also be struggling, or could very soon find themselves in that situation, as funding cuts bite further in the coming year or as our recent survey shows, struggle to replace GPs leaving the practice.

An NHS England spokesman said: 'We are aware that some GP practices are feeling the pressure of rising patient demand and we continue to work on a wide range of measures aimed at supporting GPs and tackling workload. As part of our efforts to boost primary care, we are investing £10m in struggling practices and we will announce more details soon.'

Vulnerable practices by region

* Data obtained from NHS England through a freedom of information request.

** Figures for total practices per subregion collated from Health and Social Care Information Centre publication NHS Payments to General Practice, England, 2014-15.

*** Fund allocation by subregion from NHS England letter to directors of commissioning operations, December 2015. Photo: iStock

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