Analysis by NHS England shows global sum payments to practices will rise by about £12 per weighted patient between 2014/15 and 2020/21.
Global sum payments will rise by more than £6 per patient in 2014/15 alone, because of the combined effect of redistributing QOF money, MPIG and seniority pay agreed in the 2014/15 contract deal.
Much of this will simply deliver through different mechanisms funding practices already receive.
But MPIG redistribution will deliver about a £7 per weighted patient increase in global sum funding over seven years, worth more than £40,000 to an average practice.
About 35% of practices not reliant on MPIG top-ups to core funding will benefit in full from this uplift, while for other practices, global sum gains will be offset by MPIG losses.
Some practices will lose heavily from MPIG withdrawal.
NHS England area teams have begun consulting with practices, patients and CCGs to find solutions for the 98 'outliers' worst affected.
One area team has told outlier practices they are likely to continue to receive their current MPIG payments beyond April, when the first round of cuts kicks in, until the matter is resolved.
Lancashire GP Dr Karen Massey, whose rural practice faces a £91,000 MPIG loss plus a further loss of £35,000 from the withdrawal of additional staff funding, said despite that 'real concession' won from the area team, she was 'not terribly hopeful' about the eventual outcome.
Under the imposed 2013/14 contract, MPIG top-ups to core pay will be redistributed over seven years from 2014. About 65% of practices in England benefit from MPIG.
NHS England has issued advice to area teams about outliers. Guidance from head of primary care commissioning Dr David Geddes suggested smaller practices could be merged, federated, or made more efficient by cost-cutting, among other options.
The advice said practices providing services outside their core contract for atypical populations could be funded through enhanced services or moved to a PMS or APMS contract.
GPC chairman Dr Chaand Nagpaul warned that handing decisions to overworked area teams risked further delay.
The consultation, said Dr Massey, would consider 'how much they feel we need to stay open, how much would be needed to operate as a branch practice, and the cost to the NHS if the surgery were to close'.
'There is a chance they could say it is not going to cost a lot more to keep open as you are than as a branch, but I'm not terribly hopeful.'
NHS England has said it will publish anonymised details of outlier practices shortly.
- Is your practice one of the 98 outliers? Or are you badly affected by the MPIG withdrawal but have not been classed as an outlier? Contact GP at: firstname.lastname@example.org