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
