General practitioner General Practitioners Committee England

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How will my practice be affected?

Because of the way that MPIG funding is currently distributed, approximately half of practices will gain and half will lose funding over the seven-year transition period, as correction factor funding is redistributed into the global sum.

To help practices calculate how they will be affected by these changes, NHS England has produced a ready reckoner for practices to use as a rough guide to estimate how their funding will change in 2014-2015.

Practices should note that in addition to the phasing out of MPIG, the ready reckoner takes account of the changes to practice funding that will be implemented as part of the GP contract agreement for 2014-2015.

This includes the transfer of 238 Quality and Outcomes Framework (QOF) points and retired enhanced services funding into the global sum. The changes to the GP contract for 2014-2015 were agreed as part of a separate round of negotiations to the contract imposition in 2013.

Find out more about the contract changes for 2014-2015


Outlier practices

Following the imposition, NHS Employers accepted GPC's argument that NHS England should provide individual support for those practices worst hit by the phasing out of MPIG correction factor payments, i.e. outlier practices.

For these practices, drastic funding cuts could threaten patient services or practice viability. This highlighted that the funding formula did not adequately reflect the needs and workload of practices with atypical populations.

On 18 December 2013, nine months after the confirmation of the GP contract imposition, NHS England wrote to area teams about its proposed process for providing support to outlier practices. The letter refers to 98 national outliers that could lose more than £3 per patient in 2014-2015.

This list of 98 practices is only a guide for area teams, since NHS England acknowledges that there will also be other practices that suffer a significant income loss. Many of these practices will have as strong a case for support as the 98 outliers.

GPC has consistently lobbied, as a minimum, for a nationally directed process for dealing with outlier practices for implementation by all area teams. We are therefore very unhappy with the approach taken by NHS England, which devolves decisions about how to deal with outlying practices to area teams, as well as the unacceptable delay in identifying and informing outlier practices. We have made these concerns very clear to NHS England.

NHS England's statutory obligation to ensure patients have access to comprehensive health services means that the distance patients are expected to travel to access primary care services should not be such that it places their wellbeing in jeopardy. Consequently, it cannot simply allow provision to cease.

Read NHS England's letter to area teams about outlier practices