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Has the Correction Factor got the X Factor?

I was recently contacted by a new partner joining a practice - a rare event these days - who wanted to know what the Correction Factor is, and how it relates to the MPIG.

Apparently she asked her partners for an explanation and they suggested she talked to the accountant. Within days of this call, I also took a phone call from a journalist wanting my comments on the plans for the withdrawal of the Correction Factor and the replacement for all GPs with a single contract.

I realised that there is a large degree of ignorance about the Correction Factor, the MPIG , why they exist, and how dependent some GP practices are on them.

So to recap, GPs had to vote for the 2004 contract before it was priced.  Risky business. They voted for the contract, and when the DoH subsequently issued the payment structure, it quickly became apparent (i.e. in less than one hour) that the Carr-Hill funding formula was flawed. The rumour I heard was that the DoH did not like all the components of the formula and took some out without making any corresponding adjustments.

In any event, since GPs had already voted for the contract, an urgent fix was needed. The band-aid solution invented ensured GPs earned no less from their core income than they were earning in 2003, and so the difference between the new funding promised under the Carr-Hill formula and their previous earnings was given to them as a Correction Factor. Since the Carr-Hill global sum + Correction Factor = the 2003 earnings, this idea was called the Minimum Practice Income Guarantee or MPIG.

This might sound like a journey back in history, but it is relevant today as the plans seem to be for the withdrawal of this guarantee.

The Correction Factor was intended to be a temporary solution, and it is time it was replaced. It did however retain the discrepancy between those practices that were high achievers or in areas of high deprivation. Just replacing the existing system with a simple single payment solution might appease the Telegraph GP baiters, but it denies the real differences that you find between practices. Failing to acknowledge that differences exist is demotivating for the GPs and actually lazy thinking.

The sense is that there is not the same degree of care or concern at the Centre, and we have a flavour of what is to come by looking at the PMS reviews, pretty much a one fix for all.

This is the fight that the GP negotiators cannot lose.

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