Practices are also facing cashflow problems, with some partners taking pay cuts to fund increased costs of working. GPs have also warned that underfunding is reducing capacity to maintain and expand services.
The DHSC confirmed earlier this month that extra funding would be delivered 'in due course' as part of a general practice COVID-19 support fund.
But the Treasury has yet to provide any funding or detail on how the support package will work, leaving practices out of pocket as they face costs such as locum cover and practice improvements to meet social distancing requirements and protect staff and patients.
GP leaders have reiterated that practices cannot be expected to foot the bill for these changes and have warned further delay to the funding package leaves practices in a precarious situation.
Londonwide LMCs chief executive Dr Michelle Drage told GPonline: ‘Underfunding reduces a GP practice’s capacity to employ staff, maintain premises and restock essential supplies. All of this results in fewer appointments being available and administrative delays, that are equally frustrating for patients and practice staff.
‘It is not fair to practices or the communities they serve that they should face severe financial disruption and potential bankruptcy because the NHS will not make good on its promise to reimburse the unforeseen costs created by the fight against coronavirus.
‘GPs and practice staff should not have to pay for treating patients out of their own pockets when they can clearly evidence where they have been picking up the cost of the coronavirus response, they need direct reimbursement, without deductions or diversions.'
Derbyshire LMC treasurer and BMA committee member Dr Peter Holden said partners were having to cut their own pay to fund COVID expenses. He said: ‘There are cashflow problems around because of increased costs of working, particularly in some dispensing practices where there was a major run on prescription requests in March.
‘A dispensing practice will turn over scores of thousands of pounds worth of drugs a month, and if the demand goes up three times, that's three times the scores of thousands of pounds a month, and you've got to cashflow that until you get paid, which is three months.
‘But some practices are still hand-to-mouth because they draw everything, every month, all the time… it does not matter what you do, if you incur an expense that is not budgeted for there is only one place that comes from, that's the partner's take-home pay’.
Dr Holden said his practice had been unable to secure funding to install extra doors to increase the number of patients they could see at one time.
‘The building was commissioned to deliver GMS, as originally envisaged, not to deliver GMS in a biosecure environment. That's an extra cost the government is going to have to meet because it's a cost of operation. You can't expect us to fund that from our take-home pay,’ he said.
Wessex LMCs chief executive Dr Nigel Watson said some practices had received CCG support to cope with additional expenses. However, he said that government funding must come soon to show general practice had not been forgotten.
‘The NHS long-term plan recognised the importance of general practice and community care, and moving the barriers in between. We’ve seen some steady progress [but] the risk going forward is that everybody forgets that and focuses on the hospital waiting list and allows general practice and community to slip back to where it was before,' he said.
‘Going forward this battle is going to be won or lost in the community and not just in the hospital. So they need to support general practice and we need to make sure that we expand our workforce and we don’t see it shrinking,' he added.
The DHSC has promised to unveil a general practice COVID-19 support fund 'in due course'. BMA GP committee chair Dr Richard Vautrey has warned that a package of millions of pounds was needed nationally to reimburse practices for COVID costs.