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Funding changes force Bristol GP practice to resign from its contract

by Valeria Fiore
11 December 2017

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An inner-city GP practice with over 17,000 patients has handed back its contract because it can no longer offer a ‘fair and adequate’ service to patients.

Charlotte Keel Medical Practice, which operates in a deprived area of Bristol, said its core funding had been eroded by a five-year review of funding linked to its PMS contract.

NHS England and CCGs have been redistributing PMS funding since embarking on a review in 2013, when it identified £260m worth of funding that it said was not directly linked additional patient services,although GP leaders warned it would destabilise practices.

The Charlotte Keel Medical Practice said it had applied for funding for ‘atypical’ practices to fill the gap, but had received no response from the CCG or NHS England regional team.

In line with guidance issued earlier this year, practices with large numbers of patients who do not speak English should be able to access additional funding. The practice said that because of its location in a deprived area it also has a large proportion of patients with significant mental and physical health problems.

In addition, the practice said its funding is being hit by scrapped subsidies on the rental costs of the NHS-owned premises it occupies.

It told patients in an announcement on its website: ‘On the basis of these funding changes, the partners have been forced to conclude that, from 1 April 2018, we would not be able to deliver a fair and adequate service to our patients, who already face significant health inequalities.

‘In giving notice now, before the full force of the funding cuts take effect, we trust that we are acting in the best interests of the patients and staff of the practice in allowing another organisation, with likely access to additional resources and funding streams, to take over the management of a fully functioning practice.’

The GP partners added in the notice that they hoped their ‘very difficult decision’ would ’cause NHS England and Bristol CCG to reflect on the need for an appropriate level of funding to be provided to meet the needs of our patient population in inner-city Bristol’.

The practice contract has now been put out to tender by the CCG as a two-year, time-limited APMS contract, with BrisDoc Healthcare Services Limited identified as the preferred bidder.

NHS England South West commissioning director Debra Elliot said: ‘A minority of practices such as Charlotte Keel that received more funding in the past are unfortunately having this [funding] redistributed – but most across the city are receiving more.’

She added that NHS England and NHS Bristol CCG have worked with the practice but the ‘partners felt unable to accept the support and investment we had offered to help them build a more sustainable business model, so we are now seeking to appoint an interim provider to make sure patients continue to get access to good GP care’.

Charlotte Keel Medical Practice is one of two Bristol-based practices to recently hand back its contract, with the CCG announcing that the Bishopston Medical Practice has also been put out to procurement with BrisDoc as the preferred bidder.

It is expected that BrisDoc will run the Charlotte Keel Medical Practice from April and the Bishopston Medical Practice from February.

NHS Bristol CCG chair Dr Martin Jones said: ‘The long-term solution goes hand in hand with the work we are doing across Bristol, North Somerset and South Gloucestershire to increase sustainability of primary care by supporting GP practices to work closer together.’