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The Global Sum - An outdated calculation?

It is common knowledge that the global sum for 2014/15 paid to each practice in England is £75.56 per weighted patient.  However, there are many practices who suffer due to their weighted list size being considerably less than their raw list size.  In the past they have been protected by the Minimum Practice Income Guarantee (MPIG), but from April 2014, over the next seven years, this funding is being withdrawn.

Sadly, there is little a practice can do to change the weighting of each patient.  The calculation is based on what is known as the “Carr-Hill formula” and has been in place for over ten years.  The formula is based on numerous factors such as gender, age, postcode and rurality.  Accordingly, women are given a higher weighting than men, the older the patient the higher the weighting, and home postcode of the patient provides a complete lottery.  Given this scenario, one can imagine the problem facing, for example university practices.

Inappropriately and perhaps surprisingly, the NHS have hitherto shown no interest in reviewing the calculation.  But populations have changed considerably over the last ten years which must surely affect the weightings.  Whilst nothing has been formally announced
there has been “talk” of reviewing the formula as early as April 2015.  Given the obvious flaws in the current formula, such a review cannot come soon enough. One final thought – is it more difficult and time consuming to treat an 85 year old woman than a student suffering from depression during their first move away from home?

Keith Taylor FCA

Keith Taylor FCA

Managing Director

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