Hundreds of practices face closure

GMS contract PCOs failing to provide financial support to prevalence losers, GPC warns.

Hundreds of practices could face closure because of changes to the prevalence formula, the GPC has admitted.

GPC chairman Dr Laurence Buckman said last week that primary care organisations (PCOs) were failing to offer financial support to the worst-hit practices.

'PCOs perhaps don't see this as worth bothering with or they are being directed by SHAs not to bother with it,' he said.

'Tens, maybe hundreds' of practices could be forced to close unless support was agreed soon, he warned.

Earlier this year, GP newspaper revealed that practices will lose up to £200,000 from the changes, which take effect in two stages (GP, 23 January).

In April this year, the square root component will be removed from the QOF prevalence formula. From April 2010, a mechanism that tops up quality pay for the lowest-prevalence practices will be removed.

GPs have hit out at the GPC for failing to negotiate a guarantee to protect prevalence losers.

Londonwide LMCs chief executive Dr Michelle Drage said that, in London, no PCT had begun to arrange support. 'It was a shock to find part of our national pay arrangement has been hived off to LMCs to negotiate with unwilling PCTs.'

But Dr Buckman said the terms were 'as specific as the government would allow'.

Dr Buckman told GP the prevalence deal and the core funding formula that takes effect from 2009/10 were agreed to prevent the imposition of a less favourable contract by the DoH.

Fall-out from the 2009/10 GMS deal


  • Practices stand to lose up to £200,000 from changes to the prevalence formula that weights QOF pay.
  • 'Hundreds' of practices could face closure because PCTs are failing to support them.
  • GPC criticised over failure to guarantee support for losers.

Core pay

  • GPC admits plan to distribute pay via a complex formula could create 'a new set of anomalies'.
  • GP revealed earlier this year that some practices would receive an 8 per cent core pay rise from a 2 per cent overall GMS rise, while others received just 0.61 per cent.
  • GPC and NHS Employers are in negotiations over a revised deal for core pay from 2010/11.

The GPC has also admitted that the core pay deal it agreed last year, which the DoH said could end the MPIG in five years, needs renegotiating.

The system will distribute any pay rise for 2009/10 according to a complex formula, meaning that a 2 per cent overall pay rise would boost core pay at some practices up to 8 per cent, but just 0.61 per cent for others.

The GPC and NHS Employers are now conducting a survey of practices' correction factor payments, to inform talks over a revised pay system for 2010/11. 'We are looking at a model that understands why funding goes to certain practices,' said Dr Buckman.

'If the (2009/10) model continues for a number of years it could end up with money going to practices that perhaps ought not to get it. If you keep doing it, it could produce a new set of anomalies, and we are very keen to stop that.'

Wessex LMC chairman Dr Nigel Watson said the deal was 'fine for a year.'

'This solution just gives us a holding position. For the future of general practice a more sensible solution has to be found.'

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