The General Practitioners’ Committee (GPC) and NHS England are discussing giving ‘atypical’ practices, such as those in rural or deprived areas, their own contracts to combat the withdrawal of the minimum practice income guarantee (MPIG).

Rural practices and those that treat a high number of homeless people would be particularly affected by the MPIG withdrawal as well as by the high cost of private medical services (PMS) contracts.

Therefore, the GPC and NHS England are discussing either national or local contracts for such practices, as they have already agreed that the ongoing review of the Carr-Hill Formula, which determines the basic global sum received by practices based on the demographics of their patients, will be unable to devise a formula that is fair for all.

This has long been a topic for debate, as practices with atypical populations and those in deprived areas often do not receive sufficient funding to support them. However, according to the GPC, the problem has been masked until now by the MPIG and PMS premiums which the Government is withdrawing.

A spokesman for the GPC insisted that it is not possible to have ‘one size fits all’ type contract that could do justice to the specific needs of practices that have certain atypical populations. Therefore, in some cases, it may be possible to look at a contract designed for the needs of certain categories of practices while in others, the atypical nature may be very specific to the practice, which would need a very particular arrangement.

Meanwhile, NHS England maintains that it has previously committed to reviewing the GP funding formula and restated this as part of the wider New Deal for general practice. It will therefore continue to work with the GPC on the review with the aim of adapting the formula to better reflect workload and deprivation. However, changes to the Carr-Hill formula will not be made for the 2016/17 contract.