GP SURGERY FACING 46% FUNDING CUT – BMA warns of threat facing the profession

East London GPs marching last June against GP surgery closures
East London GPs marching last June against GP surgery closures

A GP surgery facing a 46 per cent cut to its funding over the next three years embodies the threat facing the profession, the BMA has warned.

GP partners at the Slaithwaite Health Centre near Huddersfield have warned of a funding fall from £146 per patient in 2015 to £78 by 2018 as a result of NHS England’s review into GP personal medical services.

The practice has also warned that the loss of funding will lead to an almost 50 per cent reduction in total staffing, leading to drastically increased patient waiting times and additional pressure on other local health services.

BMA GPs Committee deputy chair Richard Vautrey said that the domino effect of reduced funding, struggles with staff recruitment and retention and detrimental effects on patients were becoming increasingly common within general practice.

He added: ‘General practice is under extreme pressure after a decade of escalating patient demand and falling resources, with one in three GPs considering retiring in the next five years and almost 600 GP trainee posts left vacant this year.

‘Doctors and other practice staff are working harder year on year to cope with the unprecedented strain, but while we want to deliver the best possible care for our patients, the increasing demand has not been matched with investment.

‘Rather than losing the limited amount of funding practices have, sustainable investment should be made to enable practices to cope with the rising demand. We need the government to take urgent action to address these pressures by committing to long-term investment in GP services. We cannot and should not allow vital services to disappear from our community.’

As a result of the PMS funding loss, the practice will see a 43 per cent cut to its total budget. Slaithwaite, which currently has 2.5 whole-time equivalent GPs and 1.8 nurses catering for 4,838 registered patients, would see weekly availability of GP and nurse appointments reduce from 330 to 186 and from 310 to 175, respectively.

Practice partner Paul Wilding warned that the reductions mean that the centre would ultimately be unable to provide a safe standard of care for patients. He added: ‘We do not believe that we can provide a safe service with these proposed staffing levels.

‘Same-day access will be severely restricted and the waiting time for routine appointments will be up to two weeks. ‘Slaithwaite patients will access 999 and emergency care services more frequently and the number of unnecessary hospital admissions will rise. The net cost to the wider system will be far more than the money saved from our budget.’

Meanwhile, practices are missing thousands of pounds in payments for the avoiding unplanned admissions Data Encryption Standard (DES) after NHS IT systems twice failed to accurately report their achievement, reports GPs magazine Pulse.

Many practices using Egton Medical Information Systems (EMIS) and SystmOne systems are still missing payments despite the Health and Social Care Information Centre (HSCIC) running a second round of data extraction, after the first round failed.

The BMA GPs Committee has said it was ‘unacceptable’ that IT systems had let practices down yet again, after a long-running saga of payment chaos. The HSCIC claimed that the problems affected a ‘significant minority’ of practices, but was unable to provide figures.

One practice in the east of England told Pulse that it was missing £10,000 in funding, with its report showing it had apparently registered zero patients who were most likely to have an unplanned admission, despite having in fact registered the 2% of its list as required by the DES.

The latest payment issue has come about after the chaotic rollout of the Calculating Quality Reporting System, which is intended to automatically calculate Quality and Outcomes Framework (QOF) and enhanced service achievement.

But it has been plagued by technical issues and delays since its intended launch date two years ago.

BMA GPs Committee deputy chair Dr Richard Vautrey told Pulse the committee was aware of the payment delays, saying further workload issues were a ‘huge hidden burden’ on practices and management staff.

He added: ‘It’s completely unacceptable that the central IT systems from the NHS have let practices down yet again. It’s quite understandable why practices are getting increasingly angry at the extra workload that is being dumped on them. They’ve been promised time and time again that these things would be fixed, but there doesn’t seem to be any sign of that. NHS England has to up its game and deliver.’

• THE Royal College of Nursing (RCN) has commented on new figures showing that attacks on NHS staff in the acute sector have risen in the past year, with more than 67,000 assaults reported overall.

Janet Davies, Executive Director of Nursing and Service Delivery at the RCN said: ‘It should go without saying that nobody should be assaulted whilst going about their daily work. The fact that assaults against staff seem to have gone up in the acute sector may be a barometer for the enormous pressures hospitals are facing.

‘With increasing waiting times, rising frustration and the chaos of understaffed and busy wards, staff are too often the punch bag for a care system on the point of being overwhelmed. It’s also a vicious cycle – with morale undermined, difficulty recruiting and staff off sick, patient care can be damaged and delayed.

‘Aside from the pain and distress, assaults against staff cost the NHS around £60 million which could be better spent on improving patient care and providing faster treatment. It is right that sanctions have been applied to more of the perpetrators than before, but it is still only a tiny proportion of the total. It is also likely that the reported assaults are just scratching the surface of the problem, with many going unreported because staff don’t have time or don’t believe that action will be taken.

‘There may well be instances where assaults or aggressive behaviour are related to a medical condition, but there is more employers can do to prevent incidents and reduce harm. With security staff, training, support for lone workers, safe staffing levels and a well-designed environment for care, employers can help to mitigate the risks to staff.

‘The RCN is now working with nurses and employers to encourage dignity at work and a supportive, safe workplace for all staff. This can only happen if the NHS recognises that supported staff deliver better care, and invests accordingly.’

• The RCN is throwing its support behind the Emergency First Aid Education Bill which is having its second reading in Parliament this week. The Bill, tabled by Teresa Pearce MP, requires secondary schools to give young people the skills and confidence to deal with a range of medical emergencies including cardiac arrests, heart attacks, choking, bleeding, asthma attacks, and seizures.

At RCN Congress in 2010 members voted in favour of a resolution calling on governments to mandate the teaching of first aid to school children. The RCN has also been in full support of the Every Child a Lifesaver campaign to make first aid education compulsory.

Fiona Smith, Professional Lead for Children and Young People’s Nursing at the RCN, said: ‘First aid can and does make the difference between life and death. Recent Pride of Britain Award winner, Josh Williamson demonstrated just that when he saved his father’s life through CPR – at just 11 years old.

‘However, less than one in ten people are currently trained in the basic skills. By making this a compulsory part of education, we can equip our whole child – and future adult – population with the ability to help people and potentially save lives. We hope the government will understand the importance of this Bill and fully implement first aid education throughout the country.’