GP practices face £200k cut in GMS contract reform

Practices could face six-figure swings in funding under NHS-backed plans to base practice budgets on QOF data, accountants have warned.

Dr Beth McCarron-Nash: GPC will defend current funding model (Photograph: JH Lancy)
Dr Beth McCarron-Nash: GPC will defend current funding model (Photograph: JH Lancy)

Research funded by the NHS National Institute for Health Research has shown how GMS or PMS funding could be replaced by primary care cost estimates based on QOF data.

A senior Conservative GP said the alternative funding model would appeal to the DH, as NHS Employers and GP leaders debate reforms to the Carr-Hill formula and minimum practice income guarantee (MPIG) funding under 2013/14 GP contract negotiations.

The researchers argue that funding based on practice data would be clearer and fairer than current systems and would reduce incentives to cherry-pick or 'dump' patients.

'Significant losers'
But Laurence Slavin, a partner with specialist medical accountants Ramsay Brown & Partners, said budgets based on weighted pounds-per-patient costs would in effective standardise practice profits. Some three-partner practices would see funding fall by over £200,000 under such a scheme, he warned. 'There would be significant winners, but there would probably be more significant losers.'

NHS Information Centre data suggest around one in eight practices would see six-figure income drops in such a system.

The research into funding compared different ways QOF data could be used to calculate how much money GPs need to cover the cost of patient care.

One of the researchers, University of Bristol health economist Dr Sandra Hollinghurst, said: 'A simple count of diseases performed best and, although QOF does not cover all chronic conditions, the advantage of using this measure is that practices are familiar with it and the data are routinely collected.'

GPC negotiator Dr Beth McCarron-Nash said the GPC had done 'a lot of explaining' to the DH over the years about the need to maintain current funding systems, such as the Carr-Hill formula and MPIG.

'There are those within government who think that MPIG is a bung to practices,' she said. 'In reality, there are a good many reasons why practices receive the funding level they do.'

Conservative Medical Society chairman Dr Paul Charlson said budgets based on practice data would be a 'fairer and more transparent way to fund GPs' and were likely to find supporters within the DH.

A DH spokeswoman said practice funding would be the responsibility of the NHS Commissioning Board, which is expected to hold GP contracts from April 2013.

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