NHS England has requested regional teams and clinical commissioning groups to identify what it describes as ‘atypical practices’, which are either unavoidably small and isolated or that feature large numbers of patients unable to speak English.
Such practices will then be provided with additional funding, which will be above and beyond their GMS contract allocation.
In order to advance this matter, NHS England has published guidance for commissioners outlining the practices that may be eligible for such additional funding.
NHS England states that “there are some practice populations that are so significantly atypical that using the GMS funding formula would not ensure the delivery of an adequate general practice service, including unavoidably small and isolated practices, university practices, and practices with ‘a high ratio of patients who do not speak English”.
The organisation indicates its belief that it will be possible for such practices to be supported by a bespoke enhanced service, or possibly added formally into a PMS agreement.
Factors such as the average population density and the distance from patient residence, ambulance response times, and the provision of existing services at candidate practices will be taken into consideration.
Additionally, for university practices, commissioners should assess factors such as comparative consultation rates, prevalence of disease not covered by QOF and registration data in September-October to identify student registrations and de-registrations over the summer, the guidance states.
Meanwhile, for practices with a high number of non-English speakers, commissioners should assess the percentage of patients requiring an interpreter, consultation rates compared with the average; and average length of consultation.
The guidance document notes that the process should have a positive impact on the quality of care delivered by such surgeries.
“Support for practices should directly impact on patient care as well as the long-term viability of practices, and therefore commissioners are encouraged to undertake a review of identified practices in their area. By reviewing the practices in your area, commissioners and providers can identify practices that require such support. Without this support many practices will be unable to maintain the service and as a result health outcomes may suffer.”
NHS England has already executed a working group which has examined the viability of providing additional allocation to such atypical practices.
This runs concurrently with a review into updating the Carr-Hill funding allocation, which will come into effect in April 2018.
Recent data, along with the opinion of numerous prominent individuals, has suggested that general practice is in a something of a crisis state.