Minister to investigate APMS funding threat to GP practice

A health minister has promised to look into the threat to a practice in east London which could be made unviable by proposed 43% funding cuts.

Dr Daniel Poulter: looking into threatened APMS practice (photo: DH)

The APMS Barkantine medical centre, in Tower Hamlets, faces a reduction in extended hours funding on top of cuts triggered by the NHS England area team's decisions to strip it of a walk-in service.

Lead GP Dr Stuart Bingham told GP that the combined effect of reducing the practice's hours, cutting the funding it receives per patient, and reducing the size of its weighted list by applying the Carr-Hill formula, would mean a 43% overall funding cut.

Local LMC leaders believe two practices in Tower Hamlets borough face cuts of around £30 per patient and that around 25 practices across London are in a similar position.

APMS break clauses

Commissioners are using break clauses in APMS contracts to impose the new arrangements following an NHS England national directive to separate the 8am-8pm walk-in services from the registered patients service at GP-led health centres.

Speaking in a House of Commons debate on GP services, local MP Jim Fitzpatrick (Lab, Poplar and Limehouse) said: ‘The Barkantine practice in my constituency combines a 10-handed GP practice with a walk-in centre. It is able to offer appointments from eight o’clock in the morning to eight o’clock at night seven days a week, which is what the prime minister made a big point about in his conference speech.

'However, because of restructuring, the practice is having to hand over its walk-in centre finances to the local CCG, which means that the critical mass for providing the 8am-8pm service seven days a week is no longer appropriate.’

Health minister Dr Daniel Poulter replied that he would look into the matter.

Attack on practices

Vice chairwoman of Tower Hamlets LMC and GPC member Dr Jackie Applebee told GP previously that the proposals were an ‘attack on APMS practices’ which would have knock-on effects for all local practices. ‘It threatens general practice even more than it's already threatened,’ she said.

Dr Applebee said the Save Our Surgeries campaign launched in response to the threat to local practices from MPIG cuts would stand by APMS practices under threat.

‘It's not about whether they are being overpaid,’ she said. ‘They invested the money in brilliant services for patients and fantastic premises and they all take very little money for themselves. Are we in a race to the bottom or do we want excellent services for patients?’

Shadow health secretary Andy Burnham told GP he feared NHS England had forgotten lessons from the past that led the previous government to put more money into under-doctored areas through APMS contracts.

A spokeswoman for NHS England London said: ‘There is a national directive to separate the 8am-8pm walk-in service from the service for registered patients at GP-led health centres, which remain the responsibility of NHS England - including the Barkantine practice in Tower Hamlets.

‘Discussions with the Barkantine practice have recently commenced to progress these changes. As NHS England is still in the early stages of negotiations with the Barkantine practice, we cannot comment on any potential reduction in opening hours.

‘NHS England cannot comment on the viability of the practice following the changes.’

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