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Boards overspend to operate managed GP practices

Welsh health boards overspent by more than £1m

Adrian O'Dowd

Thursday, 11 October 2018

Health boards in Wales overspent by more than £2m last year to operate directly managed GP practices, according to figures obtained by British Medical Association (BMA) Cymru Wales.

The BMA submitted Freedom of Information (FOI) requests to two health boards in Wales – Betsi Cadwaladr University Health Board and Hywel Dda University Health Board – because they have both been required to operate directly managed practices for a sustained period of time.

A “managed practice” is a practice that is run by the local health board after an independent contractor practice has handed back its GMS contract. Between October 2015 and July 2018, there were 30 GP practices directly managed by health boards in Wales.

Responses to the FOI showed that in 2017-18, Betsi Cadwaladr University Health Board, the largest operator of managed practices, overspent by more than £1.3m – increasing from a deficit of £0.24m in 2016-17 – on its allocated £8.89m budget for managing practices.

Hywel Dda University Health Board, the second largest operator, also overspent significantly in 2017-18 by £1.1m.

The figures, released at a briefing session for Welsh Assembly members yesterday, show that managed practices in both health board areas relied heavily on locum sessional GPs and salaried GPs, with an average spend of £226,851 per practice in Betsi Cadwaladr health board area.

Dr Charlotte Jones, chair of the BMA’s Welsh GP committee said: “These figures confirm what we have been saying for some time. The cost of operating directly managed practices is not sustainable.

“BMA Cymru Wales has always been clear that the most cost-effective way of providing primary care services is via the independent contractor model providing GMS services. It is better for patients, providing them with the continuity of care they deserve and provides better value for money to health boards and ultimately the taxpayer.

“We know that health boards are actively seeking to return practices to GMS status and this is something we welcome. However, we cannot overlook the fact that there are still practices in Wales who are at risk and are considering or have handed back their contract. More needs to be done so that these practices receive the support they need to remain in GMS status.

“We will continue to encourage health board’s to support practices, all of whom are facing challenging times across Wales. This would include addressing last person standing issues through active intervention on premises by taking over or guaranteeing leases, as well as addressing additional challenges and pressures to make partnership an attractive option for GPs now and in the future.”

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