Practices hit by MPIG cuts could be forced to merge

Practices hit by MPIG cuts could be asked to merge, cut staff or move to new contracts in order to continue to provide services.

Dr Geddes: 'Decisions on how to address the issues will need to be taken by area teams.'
Dr Geddes: 'Decisions on how to address the issues will need to be taken by area teams.'

Guidance issued by NHS England also suggested commissioning enhanced services to help practices worst affected by the MPIG withdrawal which begins in April. 

In a letter sent to area teams on Monday NHS England’s head of primary care commissioning Dr David Geddes outlined recommended options for area teams to consider to help so-called outlier practices.

Under imposed changes in the 2013/14 GP contract, MPIG top-ups to core pay will be redistributed over seven years from 2014. About 65% of practices in England benefit from MPIG.

In his letter Dr Geddes said he had identified 98 outsiders ‘which will lose the largest amount of funding per patient’ which will be unable to provide services with their adjusted funding.

Options reccomended for very small practices are: 

  • collaborating (for example through federation or networking) or merging with other nearby practices to provide a more cost-efficient service; identifying other ways in which the practice might potentially improve cost-efficiency, such as reviewing staffing structures; and, where appropriate, reviewing other commissioning and/or contracting options 

For practices which provide a range of services outside their core contracts, or services for atypical populations, area teams are asked to consider:

  • whether these are services that should be funded at least on a transitional basis as enhanced services, either directly by the area team or via the local CCG; and 
  • agreeing a new contract type (PMS or APMS) with the practice involved to fund some of these services through core contract, if there are special factors that warrant this approach. 

In his letter Dr Geddes said: ‘Ultimately, decisions on how to address the issues will need to be taken by area teams, after a full assessment of all the local circumstances’.

Last week GPC chairman Dr Chaand Nagpaul expressed concern that handing responsibility to ‘overstretched’ area teams could result in ‘protracted local discussions’.

The solution must be ‘directed and managed’ centrally, he said, even if funding is locally deployed.

‘We need to make sure there is a national approach to make sure this matter is dealt with swiftly and not left to local dialogue that may get drawn out right up to April,' he said. ‘We need something swiftly, and a national framework to make sure that happens.’

‘Area teams are overstretched and are not dealing with normal business in a timely manner, and this will now become an additional task for them,' he said. ‘This is not something we can afford to delay on. We are dealing with practices that are going to be suffering significant loses in resources that will impact on patient services and it is not right that a few months before April they have no detail.’

Area tems have been told to make decisions on support within their existing budgets by the end of January.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

GPs yet to receive thousands of pounds in QOF pay amid PCSE problems, says BMA

GPs yet to receive thousands of pounds in QOF pay amid PCSE problems, says BMA

Around 1,000 GP practices have yet to receive QOF payments potentially worth up to...

Vaccine gap leaves parts of England more exposed amid Delta variant surge

Vaccine gap leaves parts of England more exposed amid Delta variant surge

A far higher proportion of people have received both doses of COVID-19 vaccine in...

Bullying has continued in LMCs post-Romney review, GP whistleblower warns

Bullying has continued in LMCs post-Romney review, GP whistleblower warns

Bullying and sexism are continuing within local medical committees two years after...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

No plans to impose face-to-face GP appointment targets, Hancock tells BMA

No plans to impose face-to-face GP appointment targets, Hancock tells BMA

The government has no plans to impose face-to-face appointments targets on general...

Coronavirus: Key guidance GPs need to know about COVID-19

Coronavirus: Key guidance GPs need to know about COVID-19

GPonline provides an overview of the key guidance relating to coronavirus, including...