NHS to unveil first practices to benefit from £16m tranche of GP resilience fund

NHS England will decide by next week which GP practices will benefit first from a £16m tranche of funding to support vulnerable primary care services.

Health minister David Mowat (Photo: Pete Hill)

In response to a written question from Labour MP Steve McCabe, health minister David Mowat said NHS England would set out on 18 October 'which practices would be included in the first cohort to receive support' through the Practice Resilience Programme.

An initial deadline of 30 September was pushed back 'to allow greater opportunity for practices to self-refer for assessment', Mr Mowat said.

GPC deputy chairman Dr Richard Vautrey told GPonline that the limited funding 'must be used wisely' and that it was inevitable some struggling practices would miss out. He warned that practices must be reassured that asking for support under the programme would not open them up to a 'punitive' process.

GP funding

It remains unclear how many practices will benefit as part of the first wave of support from the Practice Resilience Programme, through which NHS England has pledged to deliver £40m over four years - £16m in 2016/17 and £8m in subsequent years.

GPonline reported earlier this year that as many as 20% of GP practices in some parts of England had been declared vulnerable by NHS officials, and a BMA poll found that one in 10 were financially unsustainable.

Mr Mowat's written answer earlier this week said the government could not estimate how many practices needed support until NHS England reported back on 18 October.

But he pointed out that NHS England's earlier Vulnerable Practice Programme had identified around '900 practices as potentially vulnerable and in need of support'. Across these 900 practices, the £16m available in the current financial year amounts to around £18,000 each.

Speaking at the RCGP annual conference in Harrogate earlier this month, NHS England head of primary care commissioning Dr David Geddes said the health service needed to 'triangulate' different sources of information better to identify struggling practices early. He warned that even high-performing practices could become vulnerable quickly and risk triggering a 'domino effect' locally if they collapsed.

GP crisis

Mr Mowat told Mr McCabe: 'Identifying practices in need of support is challenging, as there are elements which are subjective and it can be hard to measure the nature, severity and weight of issues facing individual practices. The national criteria seek to chart a middle route between those aspects that are measurable and those less tangible issues.

'The nature of the issues facing a practice can be generally grouped as follows; demand, capacity and internal issues. The national criteria acknowledges the importance of local input from CCGs and LMCs, as well as how self-referral of general practices is legitimate as a self-declaration of their support needs.'

Dr Vautrey said methods CCGs were using to identify practices in need of support varied, but he warned that it was vital that commissioners talked to practices and LMCs rather than relying on 'superficial' data such as CQC ratings.

'It must not be seen as judgmental,' he added. 'There is a fear that being on a list of vulnerable practices may be seen as a judgment that they are poor practices.'

He added that CCGs must remember that resilience programme funding was not the only way to support vulnerable practices.

'They also have their wider allocation and should be using that to support practices, not be limited just to funding from the resilient practice scheme,' Dr Vautrey said. 'A decade of underinvestment will take time to turn around. We need commitments in the GP Forward View to become reality.

'The £2.5bn gap the BMA identified in our "urgent prescription" has to be filled as quickly as possible just for the profession to stand still. By doing that government can make a strong signal that general practice has a future.'

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