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NHS told to save practices with ‘last man standing’ partners

by Emma Wilkinson
24 November 2016

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GP leaders across the country are calling on commissioners to step in to save ‘last-man-standing’ practices by taking on premises leases, redundancy payments and employment rights.

Dr Charlotte Jones, member of the national GPC executive and chair of the Welsh GPC, said fear of being left with liabilities is driving ‘a succession of resignations’.

She is calling, as part of the annual contract negotiations with the Welsh Government, for a national process that would see health boards more consistently bailing out GP partners left in the lurch.

It comes as reports have emerged of practices where the GP partners are at risk of personal bankruptcy because of having to hand back their financially unviable contract.

In Scotland, the GPC has taken part in a working group with Scottish Government and health board officials looking at how to address the last-man-standing issue, the results of which ‘will inform ongoing contract negotiations’, a BMA Scotland spokesperson said.

And in Northern Ireland, a BMA spokesperson said this was ‘one of a number of issues’ under discussion with the Health and Social Care Board.

GPC deputy chair Dr Richard Vautrey said the situation in England was less straight forward because unlike health boards, CCGs do not take on the running of failing GP practices.

But he said that GPs fearing being left in that position should urgently contact their LMC to look at local solutions such as being taken over by federations or community providers.

He added: ‘There are also a number of companies who are supporting practices in these situations so there are different organisations who could do that.’

Writing to Welsh LMCs to update them on the progress of negotiations, Dr Jones said the Welsh Government has said health boards can already step in to help partners, but the GPC will be pushing for stricter guidance in contract talks.

She said in the letter: ‘They have utilised one or two of these options on occasion, but we need to build on that.

‘They should look to support these practices and reduce the liabilities on the individual. We want to make sure health boards are using all these options to support practices in a consistent way.’

GP partners in many areas are reluctantly ditching partnerships and moving to salaried roles, in part to avoid being left with liabilities.

Practices closing across the UK

In England, practices are closing while waiting for support packages but NHS England has spent less than half of the £10m fund to save at-risk practices almost a year and a half after this was first announced.

For Wales, the GPC has warned that one in 10 practices is at risk and GP Survival found 20 practices handed back their contract to the health board in the last year.

A BBC Scotland investigation last year found NHS boards in Scotland had taken over 42 practices due to the continuing GP recruitment crisis and more handovers were on the cards.

In Northern Ireland the situations is so bad GPs are plotting an exit from the NHS, and there are fears that there will soon be a whole town without general practice because of practice closures.

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