Global sum formula review could slash GMS pay by 30%

Core pay for GMS practices could fall by up to 30 per cent under proposed changes to the global sum formula.

Proposals were put out for consultation with the profession last week in a joint document from the GPC and NHS Employers.

The document outlines options for the future of the MPIG, but does not make recommendations. Decisions about the MPIG will be taken following a separate review.

However, GPC leaders said the MPIG would have to be re-calculated if a new formula was implemented to prevent practices from losing out.

The revised global sum formula would adjust for at least five key factors. It contains a revised measure of workload, a factor to account for consultation length and home visits, two factors to deal with regional variations in the cost of hiring staff or GPs, and a factor to boost funding for ‘unavoidably small' practices that face additional costs. It could also include a factor to recognise rurality.

The decision whether or not to include rurality will significantly affect how practices global sums change under the revised formula. With a rurality factor, the biggest losers would see the value of their global sums fall by up to 19 per cent, and the biggest winners would see gains of up to 83 per cent. Without it, practices could lose up to 30 per cent or gain up to 65 per cent.

The recommendations do not include weighting to recognise ethnicity or patients who speak a different language from their GP.

Weighting for nursing home and care home residents has been scrapped, as has London weighting payment worth £2.18 per unweighted patient.

Under the proposed changes, the global sum formula would not be linked to prevalence data, although the report calls for a review of technical changes required to allow this in future.

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