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GP leaders prepare for explosive vote on practices leaving the NHS

GP leaders will be voting on whether the BMA should support some practices to become private at the first-ever England LMCs Conference next week.

The agenda also contains a motion proposing the GPC should 'publicly dissociate itself from' NHS England’s GP Forward View unless improvements are negotiated to how funds from the £2.4bn rescue package reach practices.

Representativs from England's LMCs will gather in London next Friday, 10 November, to vote on what will become GPC England policy.

GPs in Bedfordshire have proposed the motion to have GPC England look at supporting GPs who ‘genuinely feel that they can no longer operate within the NHS’ to become privatised.

Meanwhile, several motions have described NHS England’s five-year plan for general practice as ‘woefully inadequate’ and ‘pointless’, with Kent LMC demanding that ‘the GPFV is replaced by an appropriate rescue package’.

A motion at the UK LMCs Conference in Edinburgh in May already declared that the GP Forward View is ‘failing to deliver the resources necessary’ and demanded that GPC should 'ballot GPs as to whether they would be prepared to collectively close their lists in response to this crisis’.

GPC chair Dr Richard Vautrey told Pulse last month that GPC England would be discussing the potential industrial action that would involve balloting GP practices on whether to close their lists en masse at the English LMCs Conference.

Other motions relating to the plight of workload pressures on practices include a suggestions that GPC England should discuss with NHS England the creation of a new category of list closure, which would allow practices to close their lists to patients who have not changed address.

The motion proposed by Cleveland LMC says the list closure would be done ‘in the interest of patient safety’.

Further, GPs' dissatisfaction with the work of primary care support services provider Capita is reflected in a motion suggesting NHS England should end the outsourcing contract, while a separate motion is suggesting the abolishing of NHS Property Services, with CCGs taking over practice leases.

The motion adds that GPC England should consider pushing for a guarantee that the ‘last man standing’ in a partnership should have the practice building either bought back or the remaining lease taken over by the Government.

The agenda also contains motions suggesting NHS Choices and Friends and Family Test feedback is unhelpful to practices and should be scrapped.

Motions in full

Leaving the NHS

BEDFORDSHIRE: Given that a number of GPs genuinely feel that they can no longer operate within the NHS, conference calls on GPC England to urgently look at how these GPs can be supported to operate within a private, alternative model.

GP Forward View

OXFORDSHIRE: Given the vote of no confidence in the GP Forward View at the Conference of LMCs in Edinburgh earlier this year, conference insists that GPC England negotiates improvements in the GP Forward View to ensure that money reaches practices directly without additional bureaucracy or additional workload requirements, and adequate improvements cannot be achieved within one year, GPC England must publicly dissociate itself from GP Forward View.

List closures

AGENDA COMMITTEE TO BE PROPOSED BY CLEVELAND: That conference asks GPC England to enter into discussions with NHS England:

(i) to develop a new category of list closure that would allow a practice to close its list in agreement with the commissioners, and in the interest of patient safety, so that it can, for a period, decline to accept new registrations from patients who have not changed address

(ii) to improve financial support to practices taking on patients following a list dispersal with the creation of a centrally negotiated payment per patient

(iii) to work towards funding to practices taking on patients after a list dispersal flowing in ‘real time’ and not in arrears at quarter-end,

(iv) so that commissioners must agree the terms of any list dispersal with the LMC(s) involved to ensure neighbouring practices taking on extra workload are supported appropriately and not destabilised.

Premises

AGENDA COMMITTEE TO BE PROPOSED BY BEDFORDSHIRE That conference instructs GPC England to negotiate with government:

(i) an extension to the deadline for the reimbursement package including contributions to Stamp Duty Land Tax, VAT, legal costs and service charge management fees

(ii) a guarantee that the ‘last man standing’ in a partnership will have the building either bought back or the remaining lease taken over by the government

(iii) that the lease liability for non-NHS Property Services (NHS PS) should be accepted by NHS England in the same way as for NHS PS premises

(iv) to ensure equivalent investment in partner owned premises as in purpose built and NHS Property service buildings

(v) that NHS Property Services be dissolved and the properties to be devolved to CCGs

Primary care support services

AGENDA COMMITTEE TO BE PROPOSED BY WALTHAM FOREST: That conference calls upon GPC England to:

(i) make the return of the delivery of primary care support functions to the public domain a central demand in the next round of contract negotiations

(ii) urgently address Capita’s failure to correctly collect superannuation contributions in England and seek recompense for those practitioners affected

(iii) demand that NHS England prioritise PCSE service improvement with regard to financial statements so that practices can undertake informed business planning.

Source: BMA

Readers' comments (27)

  • In Kent and Medway, we have retired and semi retired cardigans - what can you expect?
    Why does the stupid Carr Hill not figure in these talks?

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  • I cannot understand how there is any doubt about this at all. This Country can no longer sustain a National Health Service that is free for all. I worked in Australia for 15 years where the service is a private one with a level of government refunds. As a GP it was a far superior service. I returned to the UK in 2004 and have seen the NHS gradually crumble. I am in a Practice with 13,000 patients. When I joined there were 8.5 doctors. Now there are 4.5. We have lost four in the last two years due to the stress of the job. The rest of us work 12 hour days. I am 66 and am worried what will happen when I go, as I shall have to go soon. Roll on privatisation!!

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  • What is the alternative to the Bedfordshire LMC's motion? That if practices fail, their doctors then leave primary care entirely? Who will that help? On the other hand, if these doctors stay in general practice (but offer themselves privately) at least some patients will get some primary care).
    The motion is simply calling on GPC to provide guidance and support to help them do this more effectively, should they choose.
    The alternative? - probably no GPs of any sort, in the entire country, in a very short time. That won't help anyone.

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  • This motion won't help. NHS England's policy for struggling practices is simply list dispersal.

    This leaves the GPs to deal with staff redundancies, divesting building liabilities and no job. This policy could probably last for several years and goes into the long grass for the next government.

    The private option already exists, locuming, agencies or GP chambers. Take your pick.

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  • An inevitable consequence of delay and deliberate ignoring of the frustration of NHS GP's over many years!No Surprise!But will anything change or improve??

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  • Just Your Average Joe

    This is what Politicians have been aiming towards for years now.

    The whole US transatlantic trade agreement required the opening up of the NHS to private markets.

    This is the wrong step - despite my support of a free NHS, it is not feasible with current demands and expectation, stoked up by CQC and marketed rights for complaints for minor issues and when patients feel kicking the practice for things outside their control (Ie Referral blocked by CCG referral triage services)

    Sadly I feel no choice now - its time for co-payments of £20 pounds a consultation for walk in patients to GP, free if we call them in for chronic disease checks.

    Same with A&E - £100 walk in charge - refunded/waived if significant medical problem which did require admission.

    For those who want to consult 3 imes for every cough/cold etc they can but the time wasted is paid for, the rest get the same level of service with shorter waits for the remaining unwell patients who would have struggled for appointments.

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  • Situation seems quite serious!

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