Exclusive: Officials review MPIG support but threatened practice fears closure

NHS England officials are considering expanding the number of practices eligible for financial support after facing losses from MPIG cuts and other funding changes.

East Londoners joined protests over MPIG cuts that put practices at risk (Photo: Wilde Fry)
East Londoners joined protests over MPIG cuts that put practices at risk (Photo: Wilde Fry)

Officials told one practice at risk of closure that they could lower the threshold that defines whether practices qualify for help under a support package won by campaigning GPs last year. Currently only 'outlier' practices - those facing losses worth more than £3 per patient - are eligible for extra funding.

But partners at Limehouse Practice in east London fear any changes could come too late to save their surgery, which serves some of the most deprived communities in the UK.

GPs at the 11,000-patient inner city practice say that unless they get immediate financial support more partners could be forced to quit after pay cuts left them struggling.

Read more: Why GP funding should be tied to deprivation

Partners at the Limehouse Practice, who are mostly part-time, have been taking home around a third of the average GP pay in order to cope with the practice’s financial situation.

NHS England previously rejected the practice’s claims that it faces losses above the £3 per patient level at which support is made available, subject to other criteria. The area team has raised its assessment of the practice’s losses from £2.29 to £2.88, but the practice insists its true losses are £3.41 per patient.

Claims by several practices about incorrect figures and calculations in January caused NHS England chief executive Simon Stevens to intervene, promising that officials would examine the discrepancies. Local officials admitted that they had used incorrect data to calculate the losses of two practices.

Last week an official told partners from Limehouse Practice they would consider lowering the £3 per patient losses threshold for financial support for struggling practices in deprived areas. The package amounts to a two-year MPIG losses reprieve.

New deal for GPs

Last week health secretary Jeremy Hunt announced £10m of funding to support struggling practices after meeting with GPs and practice staff from London practices under threat.

Limehouse partner Dr Ruth Vickers said she fears these measures could come too late to save her practice. The practice has already lost two GPs and a nurse so far this year and more may follow.

Dr Vickers said: ‘To continue our work and provide services we need an urgent stop gap solution so that our team is able to survive.Without this it is likely individuals will be forced to make painful decisions to leave.

‘At least two remaining partners really cannot continue to work. The cost of living, professional fees and expenses, for childcare for example, mean they cannot afford to work.’

Dr Vickers said NHS England officials had recognised that the practice was providing work over and above core services because of its deprived population as well as serving six hostels.

A petition to save the practice from closure has gained over 1,500 signatures.

A spokeswoman for NHS England London said: ‘An NHS England representative met with the Limehouse practice to respond to concerns raised by the practice in regard to increasing workload and financial difficulties. The intention of the meeting was to explore possible solutions both at a local and national level.

‘NHS England has been working with the BMA on updating the original modelling of the impact of the MPIG changes and is reviewing the section 96 criteria for access to support monies for those practices most impacted  upon by the changes. We welcome the £10m identified by the health secretary to develop a programme of support for struggling practices.’

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