PMS review to cut GP hours and services in deprived area

A practice serving one of the most deprived communities in south-west England will be forced to cut GP and nurse hours, and lose its counselling service when £30,000 PMS cuts take effect in January.

Patients at the Merrywood Practice protest over cuts
Patients at the Merrywood Practice protest over cuts

Merrywood Practice in the Knowle West district of Bristol faces a 6% funding cut from January under the terms of a PMS review in 2012 that aimed to equalise funding across contracts. Implementation of the cuts was deferred for two years after the practice complained the cuts were unfair, but is now set to go ahead.

GPs and supporters have handed a petition calling for the cuts to be stopped - signed by a quarter of the practice's patients - to Bristol CCG.

Practice manager Vicki Staatz said it was sad that after years of the needs of deprived communities being recognised by the NHS through extra funding, the system had gone backwards.

Deprivation impact on workload

‘It was always recognised that deprivation creates more workload, and therefore you should be able to expect more doctors per head of population, and it's all gone out of the window, and it's very sad,' she said.

Ms Staatz said she felt the practice had been effectively ‘bribed’ to move to a PMS contract with growth funding and an initial lump sum to recognise the additional workload associated with moving from GMS, and that was now being taken back.

When the practice won a two-year deferral of the cuts, Ms Staatz said, it believed that growing recognition of flaws in the Carr-Hill funding formula meant a mechanism for funding deprived practices would soon be found.

‘There were all these promises about deprivation being reviewed and we said in two years' time they'll look at it and say, yes you do need that money. But nobody's actually looked at Carr-Hill.

January cuts looming

‘We've just been doing whatever we can for the past two years. In January it happens - our counsellors will go, we will have less doctor availability, less nurse availability.

‘I kept asking the CCG how this addresses their aim of reducing health inequalities, and they just kept avoiding the question.’

She added: ‘Of the Bristol practices, 50% of the [PMS review] funding reduction came from the three most deprived practices in Bristol.’

A spokeswoman for Bristol CCG said: ‘Bristol CCG commissions a Bristol-wide counselling service for all patients in Bristol. This is an open access, fully regulated service with accredited providers and is part of a range of tailored therapies available to patients.

‘One of the drivers for the procurement of this service was equity of access to mental health services for the people of Bristol, rather than funding any individual practices to offer in-house counselling services. There are no other practices in Bristol that currently provide this service. NHS England is working with NHS Bristol CCG to ensure that primary medical care services are relevant, timely and high quality.

‘We understand that the Merrywood Practice has had three years to prepare for this funding reduction and remains one of the highest-funded practices in Bristol. The CCG will support patients to ensure that those receiving counselling services at the practice are re-assessed and, as appropriate, transferred to the relevant Bristol-wide service.’

NHS England has yet to respond to requests for comment.

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