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Changes to the way GP services are funded could threaten rural practices

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Changes to funding in GP practices could threaten the future of at least 98 GP practices, GP leaders have warned. This includes practices that provide vital services to thousands of rural patients.

NHS England has identified 98 GP practices that will lose substantial levels of funding that could place their long-term survival in question. In addition to the 98, a significant number of other practices will be severely affected, said Dr Chaand Nagpaul, chair of the BMA's GP committee.

Last year the government decided to begin phasing out the minimum practice income guarantee (MPIG) from April 2014. MPIG provides important finance to many smaller GP practices by guaranteeing a minimum level of funding that is not dependent on the number of patients a GP practice has on its practice list.

One of the GP practices concerned about these changes is a Cumbrian practice run by Dr Katharina Frey, which cares for just under 1000 patients.

'We are under real financial pressure already and cannot, because of the current funding climate, afford to employ a practice nurse. We are also having to think very carefully about how we replace senior staff. This situation will become even more pressurised when we lose the MPIG support that currently accounts for our around a third of our current core funding. We are already working at full capacity with declining resources,' she said.

Dr Nagpaul said that the government had seriously misjudged the potential impact of its funding changes, especially on rural GP services that have a small number of patients registered who may have difficulty accessing NHS services if their local GP practice closes, as they may have to travel large distances to the next one.

'It is likely that a few hundred practices will lose noticeable levels of funding, with 98 practices identified by NHS England as being at serious risk from severe cuts in their financial support that could threaten their ability to remain open.'

He also said that the situation had not been helped by NHS England's decision to devolve responsibility for this issue to local NHS managers without a framework of how to support their GP practices.

'Ministers have to get a grip on this problem urgently given these funding reductions are just weeks away from being implemented. We need to ensure no practice closes and that there is a coordinated approach to deal with this issue,' he added.

Jenny Aston, an advanced nurse practitioner and Chair of the RCGP's general practice foundation nursing group, said: 'There needs to be careful consideration of how those patients affected will be able to access services in rural areas.

'The BMA briefing makes little mention of the non-GP workforce which, if used appropriately, can help practices to run cost effectively without compromising patient care.'

The full general practice briefing paper can be accessed at: http://bma.org.uk/news-views-analysis

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