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An ugly legal case between GPs and the NHS has got uglier.

Twenty months ago, five GP practices – supported by the British Medical Association – launched legal action against NHS Property Services over a bitter dispute about money.

It has since emerged that NHS Property Services – which is wholly owned by the Department of Health and Social Care – has countersued the GPs.

Put as simply as possible, the complex feud is about whether the GPs are liable to pay charges incurred by occupying NHSPS-owned buildings.

This argument has existed ever since NHSPS was formed back in 2012, and intensified several years later when the company launched a new charging policy. For some GPs, this meant costs rose by eye-watering sums.

Agreeing terms for the buildings has proved impossible in many cases, because of a lack of paperwork.

After exhausting negotiations with each other, both parties now clearly feel the matter can only be settled in court.

The case, which could have huge consequences for more than one in 10 of England’s GPs, is scheduled to be heard in March next year.

But both the NHS and government will be eager to see this battle settled out of court, given the increasingly ugly picture this paints of the system.    

Unrealistic target

When NHS England first published its forward view for mental health in 2015-16, the target to eliminate all out of area placements by March 2020-21 was momentous for the sector.

Five years down the line it appears the mountain will not be scaled by the end of next month.

Aiming to stop sending adults hundreds of miles away from home for a mental health bed was commendable but was it realistic?

Ending OAPs would have relied on a huge injection of capital and staff to increase beds and would also have required vastly improved community mental health services. The latter could both prevent inpatient care being needed but also allow for increased discharges.

Unfortunately, a legacy from the five year forward view which was not commendable was the neglect of core community services, which did not benefit from any influx of cash or transformation focus.

Decades of under investment mean both inpatient and community mental health services were not anywhere near a good enough level when NHSE recommitted to the OAP targets in the 2019-20 long-term plan.

The trusts which responded to HSJ’s question about hitting the March deadline largely blamed covid-19 as the barrier to meeting it.

However, with the cocktail of decreasing mental health beds and a languishing community mental health service, was it ever going to eliminate all out of area placements this year?