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New GP contract to mandate practices to join primary care networks

Exclusive GP practices in England can expect changes to their contract from April mandating them to join networks of 30-50,000 patients in return for a major funding boost, Pulse has learned.

The BMA's GP Committee is in the final stages of negotiating the changes following the long-awaited publication of the NHS long-term plan, which will see primary and community care receive an extra £4.5bn by 2023/24.

The new contract is also likely to see changes to QOF and a review of funding the immunisation schemes, the long-term plan says.

Under the plans, all local enhanced services are likely to be funded by CCGs through the networks.

GPC chair Dr Richard Vautrey told Pulse that the 2019/20 contract changes, which have yet to be signed off, will require practices to join primary care networks but that no practice would need to give up their GMS contract as a result.

The long-term plan says that the 'vanguard' programme - which saw GPs working in networks and covering larger patient groups - has been successful and can now be rolled out across England. As a result, GP practices will be told to enter into a network contract 'as part of a set of multi-year contract changes', and 'as an extension of their current contract'.

The plan says: 'The £4.5bn of new investment will fund expanded community multidisciplinary teams aligned with new primary care networks based on neighbouring GP practices that work together typically covering 30-50,000 people.

'As part of a set of multi-year contract changes individual practices in a local area will enter into a network contract, as an extension of their current contract, and have a designated single fund through which all network resources will flow.'

It adds: 'Most CCGs have local contracts for enhanced services and these will normally be added to the network contract.'

The networks will have 'expanded neighbourhood teams', which the plan says 'will comprise a range of staff such as GPs, pharmacists, district nurses, community geriatricians, dementia workers and AHPs such as physiotherapists and podiatrists/chiropodists, joined by social care and the voluntary sector'.

As well as this, the plan suggests other changes to the GMS contract, including:

  • Changes to QOF, which will se  a new Quality Improvement (QI) being worked up with the RCGP, NICE and the Health Foundation, while the 'least effective indicators will be retired'.
  • A ' fundamental review of GP vaccinations and immunisation standards, funding, and procurement' in 2019 in a bid to improve immunisation coverage.

Dr Vautrey told Pulse: 'Practices are already starting to develop networks covering 30-50,000 patients. This is a contractual change that will facilitate and support that. We will have more detail on that as soon as we finalise the contract.

'Every practice will be part of a network. How they engage with that will be for them to determine but I would hope that the contract changes will make it beneficial for them, to be part of working with colleagues across an area.'

He added that this would mean 'retaining your GMS contract'.

'This builds on this contract and will not replace it. Nobody will have to give up their existing contract,' he said.

NHS England said in 2017 it was expecting '100%' of GP practices to cover networks of 30-50,000 patients by 'around 2019'.

 

Readers' comments (33)

  • Peter Swinyard

    Just for once this is not something to get all worried about but a mechanism for getting money into groups of practices. The redevelopment of the Primary Care Team as a Multidisciplinary Team at PCN level is very welcome and will reduce silo working where we are working against district nurses etc instead of with them.

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  • Skilled workforce. The age of the professions is over. For better or for worse.

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  • It’s genius in a way. They have worked out how to invest in primary care while ensuring individual practices don’t increase profits without providing additional services. Shame there won’t be many practices left to bid for this additional work.

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  • Why?

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  • National Hopeless Service

    Shit just got shitier.

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  • De-professionalising doctors just got worse.

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  • We’re graphically isolated with an elderly population. Not sure ‘one size fits all’ works for everyone.

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  • Mandating things doesn't always improve the work environment make staff "play nicely!" I find.

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  • This is nothing new. GP surgeries will close or merge. A hub model will develop. GPs are expensive-so many will be replaced by cheaper alternatives. Patient care will decline--but the traditional way of providing care is no longer sustainable. Is this the 14th 10 year plan since the NHS started?

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  • Ivan Benett

    An excellent development, essentially replicating Manchester model. Great opportunity for locality integrated teams, extended same day access, better long term condition management and continuity of care.
    BUT needs more capacity with a larger workforce to meet the needs of the locality population (which varies from one to another depending on demography and economic factors). In particular need a smaller case load per GP. Greater opportunity for flexibility of career choice and specialisation

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