14.08.14
Struggling London GP practices get short-term MPIG funding reprieve
NHS England has confirmed it will provide financial support to a small number of GP practices in the poorer areas of London that will be worst affected by the withdrawal of the minimum practice income guarantee (MPIG).
The news comes after intense lobbying from the RCGP and BMA. Staff and patients from more than a dozen practices in Tower Hamlets, one of the most deprived boroughs in London, gathered outside Downing Street last week to protest about the phasing out of MPIG, which they say threatens their long-term viability.
MPIG was introduced in 2004 to support some practices moving to the new General Medical Services (GMS) contract, and has been used to top up practices' core funding – their global sum payments – to match their basic income level.
But NHS England decided last year to move to what it called a “fairer distribution” of general practice funding by phasing out, over seven years, the MPIG and redistributing these freed-up resources into the global sum funding that all GMS practices receive.
Following the intense lobbying, Neil Roberts, head of Primary Care Commissioning (NCEL)
at NHS England for London, has outlined a short-term fix for GP practices facing significant funding losses in a letter sent to LMC chief officers in London.
He said: “As you know, global sum funding is based on the numbers of registered patients served by each practice and the demographic profile of each practice population, as measured through the Carr-Hill formula, which includes adjustments for age, deprivation, rurality and other factors. At present, practices serving similar populations can be paid very different amounts of money per registered patient. The phased redistribution of MPIG resources will put right this long-standing inequity.
“Taking into account these factors and pending the outcome of the review of the national funding formula, the London region of NHS England, in discussion with NHS England’s national primary care team, proposes to offer financial support to those practices that are losing more than £3 per weighted head of patient population from GMS funding changes in 2014-15 and where the current funding formula may not provide sufficient sensitivity to local patient needs.
“This financial support will be for 2014-15 and for 2015-16, subject to a review if in the interim there are changes agreed to the national funding formula.”
Prior to this move, the government had conceded that 98 GP practices across England could face substantial reductions in their income as a result of the MPIG changes.
In response to the short-term funding changes, Professor Nigel Mathers, RCGP honorary secretary, said: “At last, NHS England is recognising the consequences of withdrawing MPIG funding on the care of thousands of patients.
“We are pleased with this response to our concerns but the two-year respite, although welcome as a temporary measure, is not enough and a permanent solution needs to be put in place to safeguard the future of any surgery that could be at risk of closure due to the withdrawal of this vital funding stream.
“We still need a guarantee that no surgery to close – and that no patient will be stranded without the medical care provided by family doctors – as a result of these proposals.”
The BMA’s GP committee chair, Dr Chaand Nagpaul, added that this latest support is limited to only a few practices in London and for a few years. He stated that NHS England is still failing to honour its commitment to provide support to all practices facing significant MPIG cuts.
“While some practices will therefore breathe a sigh of relief for the next couple of years, this plan does not provide a long-term solution and leaves many still with no sign of help,” said Nagpaul.
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