Exclusive NHS Cheshire and Merseyside ICS plans to go ahead with cutting £1.5m from Knowsley GP practices after the CCG failed to phase out PMS payments.
A year ago, NHS Knowsley CCG proposed to remove £1.5m from its primary care budget after failing to gradually discontinue PMS payments.
At the time, Mid Mersey LMC said the CCG’s proposed funding cut would affect all 25 GP practices in the region, but its 16 PMS practices would bear the brunt of the cash removal, including one set to lose £0.5m.
Local GP leaders at the time warned local practices could be forced to shut.
Now that CCGs have been taken over by ICSs, NHS Cheshire and Merseyside ICS has confirmed it is continuing with the CCG’s plans to cut the funding from Knowsley practices.
Mid Mersey LMC medical secretary Dr Ivan Camphor told Pulse the ICS has now ‘taken up the mantle’ and is ‘trying to force the issue’.
Knowsley is the ‘second poorest borough in Cheshire and Merseyside,’ meaning ‘taking the money out of an already starved and understaffed health economy’ will be ‘absolutely disastrous for the local health services,’ he warned.
‘As far as levelling up, this is going to further intensify the differences between various boroughs and the service that’s been provided in Knowsley is going to be critically damaged.’
He told Pulse: ‘They’re having huge problems with recruitment. In some areas, they haven’t been able to recruit anybody, because nobody wants to work there. And so by taking £1.5m out of their contract, they’re destabilising general practice in Knowsley.’
He said: ‘I would have thought that the ICS might want to look at it from a different angle in the way that is supporting general practice, as clearly general practice is struggling in Knowsley.’
He added: ‘I think it’s going to cause quite a lot of problems, politically and locally, because, when branch surgeries shut, when people have to be made redundant, doctors and nurses, this is going to have an impact in healthcare, and we shouldn’t lose perspective of that.’
The ICS’s current proposal is to phase out the £1.5m over 18 months, with a start date yet to be determined, but Dr Camphor said the LMC believes that ‘it’s too short a period, considering the PMS review was meant to be staged over a four-year period’.
He explained: ‘Some of the money in the £1.5m is around the PMS review, which should ideally have happened quite a few years ago, but it wasn’t the fault of the practices that it wasn’t done, it was the CCG that didn’t implement it.’
He said: ‘The people who were meant to have implemented it in the CCG have long gone. We’ve got to find some mechanism of supporting practices through this very troubled time.’
So far, the cuts have been discussed in ICS board meetings, but Dr Camphor said if the ICS wants to go ahead, ‘they will have to enter into direct consultation and conversations with [Mid Mersey] LMC’.
He said: ‘Nothing can be done without the LMC’s say so, because this is going to have a huge impact. We’ve been highlighting this for the last year and a half on the health economy in Knowsley. This has to be taken seriously.’
CCGs have been gradually removing PMS payments in recent years after an NHS England review found practices in receipt of this money were being paid a ‘premium’ of around £260m more than GMS practices, which it claimed was not linked to providing any additional services to patients.
Under the 2013/14 contract, PMS practices with high payments were supposed to have their funding reduced over a four to seven year period. CCGs were expected to have completed reviews of their PMS practice funding by 2016.
A spokesperson for NHS Cheshire and Merseyside told Pulse: ‘Discussions have been ongoing for some time with Knowsley GP practices and the local medical committee about how to resolve an identified primary care funding overspend and to consider potential options for returning to a more sustainable funding position.
‘GP practices in Knowsley currently receive £1.5m per annum above delegated primary care funding allocations, which are themselves already the highest percentage “distance from target” in England. The new funding arrangements proposed for general practice in Knowsley will still see Knowsley receiving the highest level of primary care funding in Cheshire and Merseyside, per head of population.’
ALWAYS THE SAME STORY….LOTS OF MONEY FOR LEAFY PRACTICES LOOKING AFTER STOCKBROKERS AND FOOTBALLERS WHO NEVER USE NHS SERVICES AND PUNISHMENT FOR PRACTICES LOOKING AFTER PEOPLE WHO HAVE MAMMOTH PROBLEMS……..CLOSE THE PRACTICES AND MAKE BORIS JOHNSON EXECUTIVE PRACTICE MANAGER DEALING WITH ALL THE FALLOUT…….THE TORIES AND THEIR OUT OF CONTROL PET THE DAILY NUTTER ARE DESTROYING THIS COUNTRY AND THE PUBLIC ARE LETTING THEM DO IT !!
It is always distressing to me when figures are quoted without context.
The budget for primary care and prescribing in Knowsley 21/22 according to the CCG annual report is 75.4 million.
Usually half of that is actually for GP services.
1.5m is a significant sum, especially from the budget of those 18 practices this affects. Here it ceases to be ‘budget’ and becomes names and faces. Services that will no longer be provided. Patients who can’t be supported in the community.
This will be most noticeable in the one practice which has had a significant amount of the money.
(how much does the combined effect of inflation, and energy price rises reduce a 75.4 million budget by)
Knowsley is arguably the most deprived LA in England, it would seem reasonable to invest in the most cost efficient part of the health service above the level in areas with less need.
It is in the interests of the ICS strategic plan to reduce inequalities to not remove funding from this area.
Equally it is not right that better off practices are more likely to benefit from this arrangement.
The JSNA clearly shows need for services. This ICS strategy to reduce inequalities needs to engage with the needs of its population, and less the needs of NHSE. Any population health review of the ICS would support increasing investment in primary care in the most deprived practices.
Primary care is the NHS.
COI I hope to work in the ICS as Partnership member for primary care; the position currently being vacant…
not sure there will be any takers for levelling down in C+M TBH
Well, if this is what it takes to stop people living in deprived areas, what will be will be.
Once all the essential services, like doctors, teachers, shops, jobs, are all gone, the people can just go and live in London : I hear there are more rooms than family members at 10 Downing Street, and they have servants to look after you and clean up when you spew there too!
Yes, but… how has the additional funding been used? What is it achieving for the population and have the practices had an open book on partnership profits? Lot’s more information needed…