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Independents' Day

GP practices considering ‘John Lewis-style’ merger with local trust

Exclusive Nine practices in an English coastal town are considering relinquishing their independent contractor status to join up with the local community trust.

Under the proposals, GPs in Gosport, Hampshire, would form a new organisation with NHS Southern Hampshire Foundation Trust, which would own premises and would pay the GPs a fixed annual salary while removing their personal risk.

The practices have gone as far as submitting financial records to an accountant to see whether it would be viable for the GPs to relinquish their partnerships.

It comes as GPC has strongly backed practices to work together to form ’super practices’ as part of its vision for the future of primary care.

NHS England has also advocated integrated primary and secondary care as part of its Five Year Forward View, and these new proposals are part of the South Hampshire multispecialty community provider (MCP) vanguard, which received funding from NHS England.

Dr Donal Collins, chairman of the Fareham and Gosport Primary Care Alliance and GP lead at the South Hampshire MCP vanguard, said that the structure could be a social enterprise, or a ‘John Lewis-style’ model that would see the employees part-owning the company. 

He said that recruitment problems and fears over pending retirements had led practices to consider giving up their independent contractor status, but only as part of a larger organisation. 

He added: ’I think if we were just looking at the practices and came up with a salary option that probably isn’t going to change much, but if we all get together and the whole business model changes, then we should be able to make a better, more attractive financial offer than what you are currently receiving.’

Dr Collins said that nine out of 11 practices in Gosport are looking into the model, which could take the form of a ‘John Lewis-style’ structure. 

He said: ‘You could have a John Lewis model where all of us, the workers, own it and that is something to be decided by the workers in the area. It is my preference but not necessarily what the majority might want.

Practices have been asked to send their accounts to a medical specialist accountant, with the view to combine these with the NHS Southern Hampshire Foundation Trust, and come back with a firm financial offer to GPs to work in a new ‘risk-free’ model.

NHS Southern Hampshire Foundation Trust, has already taken over premises and staff of one GP practice in the area struggling to keep afloat amid pressures, but Dr Collins said this was a temporary measure to shore up the practice until the MCP model develops.

A spokesman for Fareham and Gosport CCG said: ’The CCG recognises the current sustainability challenges of general practice in all areas of Fareham and Gosport, which are particularly acute in Gosport.

’We have recognised and supported the opportunity of practices working collaboratively and to scale to enhance sustainability and to enable new ways of delivering care for local people that improves their experience, reduces costs and enhances the quality of services.’  

Readers' comments (12)

  • Such total fragmentation of GP contracts is going to make future GP negotiations impossible.

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  • Hmm. Wait until you all have your job plans reviewed by a team of external management consultants brought in by the trust to replace you with nurse practitioners and physician assistants. You won't have a leg to stand on and if you think getting into bed with a hospital trust is risk free, think again. Employment law has never been weaker than it is now, and will weaken.

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  • call me cynical but is this just close to retirement GPs cashing in on premises equity and retiring early?

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  • Why would you send your accounts off prior to potential negotiation?

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  • Anonymous | Sessional/Locum GP02 Oct 2015 10:28am

    Surely that would be a very smart exit plan?

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  • Wonder what this 'risk free model' is? Does that mean that we don't need indemnity or to abdie by tax legistlation? Quite an odd and perplexing term. Can there be 'no risk'at all in primary care?
    Forgive them...for they know not what they speak

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  • Vinci Ho

    It is about survival .

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  • Ivan Benett

    Good luck to them, it's a model that's worth a try. There'll no doubt be a range of responses, but if they are going into it with their eyes open, then why not. Nothing is risk free, but the opportunities are potentially great. A bit of encouragement, rather than the cynical 'it'll never work' approach would be a welcome change in these columns. Well done!

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  • Anonymous | Practice Manager02 Oct 2015 12:29pm

    Yeah it is!

    They will get shafted by managers and quit, but at least they'll have their huge premises payout.

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  • I expect the tories will be bringing back workhouses as well, staff will be expected to work unpaid but may be entitled to a bit of bread and water and a blanket to kip on between shifts

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