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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'.


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  • Dr Richard Vautrey

Readers' comments (33)

  • Bob Hodges

    We're doing this already, which is why we merged in the first place. Some funding would be nice though.

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  • Really does mean the end of Partnerships running General Practice. Get out now. This is General Practice entirely on the Government [of the days] choice. The bureaucrats must be rubbing their gold plated pencils devising many hoops you'll have to leap though to bid for their work. This will be General Practice as per protocol. To meet certain demands that shows a policy is working.
    GP was and should be about continuity of care - that's where the long-term savings really are. Enlarging Practices without the capable, experienced and committed workforce will only undermine this. It will have to be run by managers set on hitting a target. How often do we experience duplication of investigation? Good money is going back into general practice. Bad - it's too late. The current belief that technology will solve the nations health problems is bizarre. Technology, good as it is has also created the problem. Good luck to you all as I am now there.

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  • David Banner

    The final nail in the small partnership coffin. Mind you, there were plenty of nails hammered in to us over the last few years. It almost comes as a relief, to be honest.

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  • Why does seem like more of the smelly soggy brown stuff we have been fed over the past 5 years oh yes it still is more of the same.Cant see how this will increase funding, decrease workload or stop the exodus.Pathetic.

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  • In theory, this is not one size fits all as you could arrange the MDT in such a way as to suit your patient population.

    For elderly, more staff to support care homes and a better social model.

    For a more rural population, better visiting services and remote working, etc

    In theory..

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  • Let common sense prevail

    I am notoriously resistant to change, but in this case do not feel overly anxious. By forming small groups we can still retain control over how we run our own practices, so I think these developments may potentially preserve the independent partnership model and continuity of care. I can buy into this one (although the devil is always in the detail).

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  • Funding will work when corruption ends especially in some areas of the southeast.

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  • This model has been implemented in Wales for some 8-10 years.
    What is the governments favourite tactic when it comes to defending NHS England?
    - some thing along the lines of,"you ought to be thankful you don't live in socialist controlled Wales."

    I know we're not good at looking at best practice elsewhere in the world eg the Antipodes,but come on,how about somewhere that is less than 100 miles from Whitehall,that would make a good start.

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  • Reality: GPs leaving/retiring early. Surgeries closing down.

    Narrative: let's create "networks" (because we don't have enough staff and surgeries are closing down).

    A lot of this stuff is clearly government propaganda. They are clueless about how to deal with the healthcare crisis and have simply retrofitted a narrative to make it look it's part of a grand plan instead of desperation.

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  • Really from my point of view this is ok.
    There’s enough self delusion and incompetence in the plan to keep me happy. So a few enthusiasts want to squander the goodwill of the few remaining doctors by enforcing more pointless dogma. So what.

    I don’t think any medical staff will be about to undercut my rates in the few years I’ve got left.

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