LMCs boycott practice boundary pilots in London

Four London LMCs have advised practices not to take part in practice boundary pilots over fears they could trigger 'unacceptable' cuts to services.

Dr Boomla criticised the pilots for failing to allow practices any say in whether patients register as an ‘out-of-area registered patient’ or as a ‘day patient’.
Dr Boomla criticised the pilots for failing to allow practices any say in whether patients register as an ‘out-of-area registered patient’ or as a ‘day patient’.

GPs in the Tower Hamlets and City and Hackney PCT areas received a letter on Friday advising them not to take part in DH-led pilots set up as part of the 2012/13 GP contract agreement.

The DH is seeking volunteers for pilots in London, Manchester and Nottingham that will allow patients who live anywhere in the country to register at participating practices. The practices will also allow 'out-of-area' patients up to five consultations without registering. GP leaders have slammed the £12.93 per patient funding for these consultations as 'pathetic'.

The letter to London practices warned that under the pilots, Tower Hamlets and City and Hackney PCTs would be left to cover the prescribing and secondary care costs of commuters living outside their local area.

The LMCs warned that the increased expense would force the PCTs to cut services for existing patients in two of the most deprived PCT areas in the country.

They also criticised the pilots for failing to allow practices any say in whether patients register as an ‘out-of-area registered patient’ or as a ‘day patient’.

The letter was signed by the chairs of all four LMCs covering the pilot area: City and East London LMC chairman Dr Kambiz Boomla, City and Hackney LMC chairwoman Dr Deborah Colvin, Newham LMC chairman Dr Prakash Chandra and Tower Hamlets LMC chairman Dr Sella Shanmugadasan.

The LMCs urged practices not to take part in the pilots unless the government agreed to fund the secondary care, community care and prescribing costs which arose due to the pilots.

A spokeswoman for the DH said: ‘The guidance issued to GP practices in the pilot area by the Department reflects the discussions and views of the GPC of the BMA who agreed that the pilots should operate in order to test potential new arrangements.

‘Analysis suggests that those people most likely to register as ‘out-of-area’ patients will be relatively young and in work (aged 18-35 without long term conditions). The average cost of hospital or other care for these patients is relatively low and therefore are not expected to be significant new costs during the pilot period.

‘Nevertheless, we have asked PCTs (and emerging CCGs) to monitor the secondary care costs associated with out-of-area registrations and this will allow the NHS, through PCTs, to manage any cost impact through their planning and financial management arrangements. We expect the pilots to begin from 30th April 2012.’

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