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GP-led firms are the big APMS winners

By Gareth Iacobucci

Companies led by GPs are the big winners in the Government's rollout of APMS services and are dominating the bidding for services across the country, a new analysis reveals.

But a new breed of business-minded GPs are blurring the boundaries between general practice and the private sector and in some cases pitting GP against GP.

One GP-led company has now secured a contract to run services hundreds of miles from the practice at which it is based, yet local GPs are often struggling to win bids.

Academics from the Health Services Management Centre, based at the University of Birmingham, found that since 2004 113 tenders had been won by new market entrants, including a long list of new born GP companies.

GP-led firms have won ‘significantly more practices than either corporate providers or social enterprises', it adds.

Well known companies such as United Health, Atos and Care UK make up just 9% of the total figure, with GP-led companies gaining 89% of contracts, and not for profit social enterprises the remaining 2%.

But the researchers admitted it was now increasingly difficult to distinguish between GPs and private providers.

Professor Chris Ham, professor of Health Policy and Management at the University Of Birmingham, who led the research, said ‘Quite a lot of the GP bidders have turned themselves into separate companies to bid for contracts, and quite a lot of the corporate bidders have strong GP involvement. The categories we've been using in the past are increasingly unhelpful.'

The rise of APMS has had another controversial twist, pitching local GPs against bidders often from far afield. Pulse revealed in September that many local GPs had failed to make it past even the initial stages of bidding for Darzi centres.

Professor Ham said the research had revealed widespread concern about the quality of local bids, which had been embarrassed by more professional bids by GPs turned entrepreneurs.

‘This had created a tension between needing to ensure the conditions for open and fair competition, but wanting to support and encourage local practices to bid.'

Local GPs have often found themselves outgunned. Last week, Kent-based GP group Malling Health was announced as preferred provider for a new Darzi practice in Weston-Super-Mare, North Somerset, nearly 200 miles away.

Dr Peter Maksimczyk, a GP in Weston-super-Mare, who lost out to the Malling Health bid said: ‘I can't see how GPs from Kent can pick up the difficulties. Practice is different in towns like Weston. It's very difficult to see this as anything other than a complete slap in the face.'

But Dr Thomas Reichelm, development lead for Malling Health, said: ‘We're aware there might be some initial rejection but we're fairly confident that by meeting people in person, we'll be able to convince them we have no bad intentions.

‘We've already started the process of finding out the local sensitivities and what matters locally. It's quite refreshing to bring a new outlook and perspective.'

Defining ‘new' primary care providers

GP-led companies
Companies set by GPs for the purpose of bidding for general practice and other primary care contracts. Have access to NHS pension scheme. Key players: Chilvers McCrea (37 practices), SSP Health (11 practices), Aston healthcare (9 practices), Intrahealth (8 practices)

Corporate providers
Investor owned companies, usually operating for profit. Do not have access to the NHS pension scheme. Key players: United Health UK (5 practices), Care UK, (3 practices), Atos healthcare (2 practices).

Social enterprises
Not for profit organisations – often set by groups of healthcare professionals, which reinvest any profits back into the organisation. NHS staff still transferring into new social enterprises and delivering NHS care can stay in the NHS pension scheme. Current players: Central Nottinghamshire Clinical Services, (Nottingham) Willow Bank (Stoke)

Source: Health Services Management Centre - Choice and Competition in Primary Care: Much ado about nothing?

GP-led companies the big winners in the battle for APMS practices

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