Primary Care in Wapping & St Kat Docks GP Update

Picture1 UPDATE, 17 June 2014 – Cllr Julia Dockerill has now had private meetings with Dr Patel and NHS primary care commissioners, Paul Bennett and Neil Roberts, about the future of St Katharine Docks GP Practice.

The way in which primary care is commissioned is highly complex, making this a rather difficult issue to distil into an interesting news article or soundbite. But here goes…

GPs are not employed by the NHS but are independent contractors whose contracts are negotiated centrally through annual talks between the British Medical Association and the NHS. Every year a fresh financial settlement is reached which is then applied to all contract types, calculated using a national formula known as Carr Hill.

In 2004, everyone had to change from their old contract to a new one. GPs could choose whether to take a GMS contract or a PMS contract. The majority of GPs in Tower Hamlets went onto the GMS contract. To bridge the gap between contract types, the Minimum Practice Income Guarantee (MIPG) was introduced. In 2012, the Department of Health gave notice to the BMA that MPIG would be phased out in 2014 over a seven year period. The money would not be cut, rather returned to a central pot (the Global Sum) and reallocated to GP practices to ensure all funds would be more equitably distributed.

Under the new regime, some GP practices will do much better, others worse. How funds are redistributed is based on a surgery’s patient list and the type of patients served, calculated using Carr Hill. Carr Hill weights patients in terms of their need.

When Julia spoke to them, the NHS commissioners accepted that the Carr Hill formula is probably not sensitive enough with regard to the practice populations in Tower Hamlets (for instance its failure properly to take into account co-morbidities in the male Asian population aged 40-45) and advised that a review is underway in this regard, due to report this year and be implemented next.

In terms of helping the SKD practice, they advised Julia of a range of steps they are taking. We do not wish to outline those steps on this website at this stage since it would represent a breach Dr Patel’s business confidentiality.

Julia also asked about the commissioning of primary care services in Wapping in general, particularly when it comes to the London Dock development and the increase in Wapping’s population. The NHS takes the lead when it comes to planning with the local authority and clinical commissioning groups how to provide services when a big new development is coming to an area. Between them they work out the pace of necessary change (for instance, if a development is coming ‘online’ over several years), the number of residents who will need primary care services and what is needed to handle the influx. They also look at the capacity of existing GP practices in the local area. A plan is then devised to determine whether new premises are needed or not and if so, whether they need to procure a new practice or whether it can be arranged for one or more of the existing practices to move into the new premises.

This process is now underway for the London Dock development and we shall be keeping an eye on the section 106 money that should be designated to increasing local service provision.

 


ORIGINAL ARTICLE – 9 May 2014

We share residents’ worries about the future of Dr Sarit Patel’s St Katharine Docks GP practice, which has been put into question following funding changes. Dr Patel has a stellar reputation here and residents do not want to lose his expertise, personal touch and continuity of care.

After hearing the news, we made immediate representations to Dr Anne Rainsberry, the NHS’s Regional Director for London, to ask for the full facts. We have now received this reply from her – RainsberryLetter

Dr Rainsberry explains that the practice is one of a number of GP surgeries in London affected by changes to the Minimum Income Practice Guarantee (MPIG), which came into effect in April 2014 (she goes into detail on this in her letter.) The changes are designed to bring all practices into an equal financial position. At present, practices serving similar populations may be paid very different amounts of money per registered patient. The changes aim to match practice funding to the number of patients served and the health needs of those patients.

The majority of practices in London will receive more in their global sum payments as a result of these changes, but there is a small number which stand to be worse off. Unfortunately Dr Patel’s practice is one of them. A working group has been set up to support affected GPs and consider what arrangements might be put in place to help them in changes they will need to make.

The local area team has offered to meet Dr Patel to discuss how the St Katharine Docks practice can be supported. We have alerted Dr Patel’s practice manager to this offer and have also offered any assistance we can in taking the next steps. We shall be getting in touch with the area team regardless to see what plans they have in place for primary care in Wapping for the future, particularly considering the big new London Dock development.

As ever, we shall post any additional news on this website as soon as we have it. Please be assured we are doing what we can to keep this fantastic local surgery open.

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