London's top GP has broken ranks with GPC leaders to warn that changes to the prevalence formula agreed last month could put UK practices in fin-ancial difficulty.
The deal had not been thought through and 'wasn't the best way to do it', said Londonwide LMCs joint chief executive, Dr Michelle Drage.
The full extent of practices' losses could provoke a reaction similar to 'Black Wednesday' in 2003, when MPIG was formed, said Dr Drage.
Despite GPC chairman Dr Richard Vautrey assuring GPs that 'no practices will go down because of this', Dr Drage said practices were in danger.
She was sceptical that PCTs would agree to extra payments for struggling practices, as the GPC hopes.
Dr Drage also appealed for practices in London to improve their customer services skills and open their lists to fight off private competition. Variation in services was preventing local GPs winning tenders and investment, she warned.
Londonwide LMCs has had to expand its GP support team by 25 per cent and recruit ex-NHS management staff to respond to the growing number of practices facing contract performance procedures.
Dr Drage said practices with unhelpful or rude staff were 'easy targets' for PCTs.
'I'm running the risk of being shouted down by my colleagues but we have to face up to the weak parts and deal with them, rather than pretend they don't exist.'
Guidance will soon be issued by Londonwide LMCs on improving basic customer services and marketing skills.
Although the threat from the private sector has 'gone quiet', it will return when the economy recovers, Dr Drage warned.
She aims to secure some of NHS London's £300 million surplus for investment in existing GMS practices rather than APMS health centres this year.
GPC negotiator Dr Chaand Nagpaul said practices could identify gains or losses using the BMA's online calculator.
He said that the GPC had seen areas that were deve- loping sensible assistance for practices.
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