NHS England criticised over plans to replace struggling practices

NHS England will draw up plans to replace GP services as soon as a practice is placed into special measures by the CQC, officials have revealed.

Rating: practices rated inadequate could be placed in special measures

The watchdog has said up to 200 practices are likely to be rated 'inadequate' and would be placed in special measures if they fail to improve.

Practices in special measures will pay up to £5,000 to cover half the cost of 'intensive peer support' from the RCGP under a 12-month pilot commissioned by NHS England. NHS England will pay the other half.

GPC deputy chairman Dr Richard Vautrey warned replacement plans could knock the confidence of vulnerable practices at a difficult time, when the onus should be on supporting them. The £5,000 bill for support could be the final straw for struggling practices, he added.

'Final chance to improve'

Practices rated 'inadequate' that fail to improve within six months will be placed in special measures and expected to make 'significant changes to improve their services'.

Special measures should allow practices a further six months to turn care around before they face legal action or forced closure.

CQC chief inspector of general practice Professor Steve Field described special measures as a 'final chance' for practices to improve.

But an NHS England spokeswoman said it will 'prepare a transition and contingency plan' as soon as a practice is put in special measures to 'cover the risk that the practice loses its registration and has to close'.

She said: 'Alternative arrangements will be investigated to ensure that patients remain able to access high-quality local general practice services.' This could include establishing a new practice or arranging for another nearby practice to take over, she added.

Onus should be on support

For struggling practices, Dr Vautrey said this 'certainly won't help them or give them the confidence that NHS England is serious about trying to offer them support'.

'The onus should be on trying to provide necessary support and resources for practices that are often struggling through no fault of their own,' he said.

Being forced to pay £5,000 to access much needed support 'could be the straw that breaks the camel's back', he added.

'The reality is that some practices will be in very difficult situations due to chronically poor levels of funding that they have received over many years. What practices are looking for is genuine support, rather than yet another bill to cope with.'

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