PCTs told to merge practices that lose on prevalence

National guidance for PCTs suggests merging practices that are no longer financially viable because of changes to the prevalence formula in 2009/10.

Fay Wilson (photograph: Wilde Fry)
Fay Wilson (photograph: Wilde Fry)

Practices that lose out could also be switched to APMS contracts, the advice says.

Guidance developed by Primary Care Contracting, an NHS body that promotes best practice in commissioning and contracting, says PCTs should not promise financial support to practices facing losses.

The document makes clear that it is ‘mandatory’ for PCTs to open discussions LMCs or practices that lose out.

But it cites ‘risks of adverse publicity from losing practices and LMC’, and the opportunity to ‘put a positive spin on this’ as key motivating factors.

Prevalence losses, which will run to six figures for some practices, could force tens, possibly hundreds, of practices to close if alternative funding arrangements are not agreed by April, according to the GPC.

But the PCC guidance advises PCTs not to set a precedent by funding local enhanced services (LESs) for practices struggling financially.

West Midlands GP and GPC member Dr Fay Wilson said that a small number of PCTs would like to destabilise practices to watch the market develop in general practice.

‘They tend to play with it like a train set, not like they are trying to get the best care for patients,’ she said.


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