I am the Chief Executive of the Suffolk GP Federation. The first part of this article is wrong and misleading.
A year ago Suffolk Fed initiated a discussion, with our 60 member practices, around different strategic options to address the pressures and sustainability issues. These included going salaried, merging, creating mini-federations and super-partnership.
A group of 14 practices have decided to form a single-partnership and this is their decision and nothing to do with the Federation. It was never expected that all practices would want to join the single-partnership.
The Fed is supporting the single-partnership with project management but we are also supporting member practices who are following other strategies, particularly collaborative working within localities.
This is the way the Suffolk PM Challenge Fund service works (we call it GP+) and the feedback from practices is very positive. Clinicians like working in the service so we don't have any problems staffing it (and only a tiny number used to work in Out of Hours so its not diverting capacity from there). We have no reports of GPs reducing shifts in practices to work in our service.
Our conclusion is the supply of GP time, using an economics phrase, is elastic i.e. in a nice positive working environment, lots of support, IT works (mostly!), decent pay, 15 minute appointments etc means GPs are happy to do extra shifts now and then, on top of their practice work.
I realise this does not reflect the views on here but it is our experience.
The practices in Suffolk said they were too busy to provide 7 day working so our service is run by the Suffolk Federation. I can confirm the CCG did not take any of the funding. In Year 1 the admin costs were high as we had to buy a lot of IT and set it all up from scratch. They are dropping and the cost structure is similar to that of a practice
Suffolk has slots that open at different times of the week (e.g. you can book sunday any time). We monitor how much an individual practice uses the service and can restrict if needed. However, the idea is to support practices particularly if they are under a lot of pressure. We also want to fill all the slots which does not fit with giving each practice a quota. We have had no major issues beyond grumbling around availability on very busy days when everyone wants them.
None of the issues raised on this discussion board are complicated to resolve.
For those who still think they want individual practices to open - they don't
The NHSE guidance says the £6 will be commisisoned from hubs not from individual practices.
In Suffolk (I am from the Suffolk Federation) we had lots of concerns before we started our scheme last year. Could we staff it, would it shift staff from in-hours to OOH (or from OOH to the 7 day service), would patients use it, was it just a glorified ad on for the worried well etc etc. All the same as the concerns expressed on here.
In reality none of these concerns have been realised. Staffing has neither been an issue or affected practices or OOH, practices are able to book the vast majority of slots so it has relieved pressure on them, patients like it (but Sunday is typically quiet).
All in all it has worked much better than expected.
This happened two years ago in North East Essex when all outpatient diabetes care moved out of the hospital. Practices are paid for the work and have access to really good and responsive clinical support. Outcomes have improved and it has worked well. It was done as part of an initiative to improve outcomes not cost cutting.
I am the CEO of the Suffolk Federation and unfortunately the article is incorrect in one instance and misleading in several anothers.
The Suffolk GP Federation was successful in the full open tender for the service, which included other bidders. If anyone is interested we can show you the 160 odd pages that we had to prepare (in four weeks)! If you are interested in knowing more about us we have a comprehensive website (www.suffolkfed.org.uk).
The Suffolk Federation is based in Suffolk whereas the contract is in North East Essex which is a different CCG. The Suffolk Federation has no member practices in North East Essex.
The contract is what is called a 'prime contractor' which means the Federation will have a fixed budget to deliver all diabetes services including screening, education, primary care, community and most of current secondary care activity. The contract, from this perspective, is a significant challenge to deliver but which we believe a GP led organisation is best placed to be successful.
Finally, the Suffolk Federation has a superb opportunity to demonstrate how clinically led primary care organisations can deliver real change including transferring, with resources, services from secondary to primary care. We would hope this would elicit interest and support from primary care colleagues across the country.
This article is not well researched. The 300 pages includes the standard NHS contract and other papers which you don't need to read. Usually it is more like 30 pages.
Also Public Health LES will be tendered on County wide basis so individual practices could only bid if they did so to cover the whole area (unlikely).
Having said all that bidding is time consuming and expensive so best done via federations
We have complete separation of GPs involved with the CCG and those on the Federation Board or the practice GP representatives on the Federation. The CCG follows its normal approach to managing conflicts.