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COVER STORY THIS MONTH


funding. The Victoria Park Practice in Bridgwater, Somerset, is on the risk list, but had no idea of this until contacted by Pulse.


We were given just a few days to apply for the scheme Dr Hussain Gandhi


Practice manager Paul Cawkwell says:


‘We are in one of the most deprived areas of the country and our PMS premium funding used to pay for an extra doctor. NHS England is not doing anything to sustain us; they are taking money off us.’ In some areas NHS managers have


asked practices to apply for the funding, but with a challenging timeline. Nottingham GP Dr Hussain Gandhi says his practice heard about the scheme just days before the deadline: ‘We were contacted about the scheme, but receiving the information just a few days before the deadline meant applications were rushed.’ Many LMCs have not been consulted


about the scheme and have little idea about which practices will benefit. But Dr Peter Graves, chief executive of Bedfordshire and Hertfordshire LMCs, tells Pulse he has been able to work with the area team to push forward incentives the LMC has developed to get retired GPs back into practices and a diagnostic tool to enable early identification of struggling practices so they can be assessed and given appropriate support. But Dr Graves is not convinced £10m will in itself make much difference: ‘I honestly don’t believe pumping a bit of money into one particularly vulnerable practice is going to have a long-term effect. Potentially it will just stave off the moment of truth and cause a bigger impact on local practices when that moment comes. ‘We’re trying to make sure this money


is being utilised in a way which is more sustainable.’ Many practices in trouble will hope he and others succeed.


Is your practice vulnerable?


NHS England has detailed a series of factors that together signify whether practices are ‘vulnerable’, and should therefore be prioritised for funding from their local area team. They include: A CQC rating of ‘inadequate’ or


‘requires improvement’ Individual professional performance


issues A high number of patients per whole-time-equivalent GP A high percentage of GP sessions not


routinely filled Low QOF achievement – specifically


those practices with a score of less than 85% High referral or prescribing rates –


where a practice is in the upper quartile for aggregate prescribing performance or referrals when compared with the average across the CCG


A recent application for a list closure Low GP Patient Survey scores for:


‘Would you recommend your practice to someone who has moved in to the local area?’ Low GP Patient Survey scores for


ease of getting through to the practice by telephone Issues with practice leadership (such


as partner relationships) – the guidance admits this is ‘hard to define’ so commissioners will need to justify any risk rating Significant practice changes –


‘splitting’ is of more concern than ‘merging’ as the latter may be for positive reasons’ and may make practices more ‘resilient’ Significant concerns from LMC, CCG or NHS England


Source: NHS England letter to area teams, 7 December 2015


Where next for Pulse’s campaign?


Pulse has been calling for emergency support for vulnerable practices since it launched its campaign in August 2013. But the


battle is not won. NHS England’s £10m pilot does not go far enough and we will continue to publicise the problems practices are having across the UK and lobby politicians and NHS leaders to ensure that they provide more support for those that are struggling. We also will continue to push for a long-term solution to make practices more sustainable. If your practice is struggling then


please let us know and we will aim to publicise your case and give you as much assistance as possible. Please email in confidence: editor@pulsetoday.co.uk.


Pulse February 2016 21


PRACTICE CLOSURES


STOP


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