The Petition of a resident of the UK,
Declares that the Petitioner believes that the GP Surgery in Coniston, Cumbria will close unless the Government’s funding formula is changed to support rural practices and further declares that the Petitioner believes that the GP Surgery in Coniston is vital to the local community as those in Ambelside and Ulverside are not easily accessible to Coniston residents.
The Petitioner therefore requests that the House of Commons urge the Government to change their funding formula.
And the Petitioners remain, etc.—[Presented by Tim Farron, Official Report, 15 October 2013; Vol. 568, c. 704.]
[P001229]
The Petition of a resident of the UK,
Declares that the Petitioner believes that the GP Surgery in Hawkshead, Cumbria will close unless the Government’s funding formula is changed to support rural practices and further declares that the Petitioner believes that the GP Surgery in Hawkshead is vital to the local community.
The Petitioner therefore requests that the House of Commons Commons urge the Government to change their funding formula.
And the Petitioners remain, etc.—[Presented by Tim Farron, Official Report, 15 October 2013; Vol. 568, c. 704.]
[P001230]
Observations from the Secretary of State for Health:
The Government are concerned to hear that the petitioner believes that the GP Surgery in Coniston, which he feels is vital to the local community, may be at risk of closing.
The formula used to fund primary medical care through the General Medical Services (GMS) contract, which includes funding per patient weighted to reflect factors such as age and rurality, is the result of negotiations between the Department of Health and the General Practitioners’ Committee (GPC) of the BMA. From 1 April 2013, the role of the Department in negotiating the contract transferred to NHS England, which is committed to ensuring that patients in rural areas can continue to access appropriate GP services, as they move to more equitable funding arrangements over the next seven years.
The formula also includes the Minimum Practice Income Guarantee (MPIG), which is a “top up” payment to some GP practices and was introduced as part of the 2004 GMS contract. It was designed to smooth the transition to new funding arrangements, whereby additional funding was provided to GP practices through the Quality and Outcomes Framework and enhanced services.
NHS England considers that MPIG payments are inequitable because practices serving very similar populations get paid very different amounts of money per patient. This is also the position of the Department of Health.
NHS England is committed to ensuring that there is a fairer system of funding for all GP practices, with money for GPs shared more equitably depending on the numbers of patients they serve and the health needs of those patients.
As part of the contract settlement in 2013, it was therefore decided to phase out the MPIG top-up payment that some practices have received over a seven-year period, starting in April 2014. The money that this releases will then be used to increase the basic funding that all practices receive for the number of patients they serve, so that these savings are distributed across all practices in a more equitable way that reflects the needs of their registered populations.
NHS England anticipates that over three quarters of practices will gain extra funding through these changes and while some will lose funding this will be managed over seven years to allow all practices to adjust to different payments gradually.
Next steps
NHS England is also committed to working with the General Practitioners Committee (GPC) and other stakeholders over how to handle the very small number of outlier practices where MPIG payments make up a significant proportion of their income. Different contracting arrangements may need to be considered to ensure appropriate services for their local populations.
This work is currently being taken forward and NHS England will engage the GPC in discussions shortly with regard to this.