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Practices' core funding under threat from PM's new voluntary contract, says GPC

The GPC has warned practices contemplating the Prime Minister’s new voluntary GP contract that they could lose contractual protection for core services and become vulnerable to takeover.

Guidance released by the GPC said it was not sure whether it ‘will be possible for GPs to maintain a ring-fenced budget for core work’ under the swift movement towards new models of general practice.

It added that the new voluntary GP contract, set to be rolled out to practices with at least 30,000 patients and offering seven-day access from 2017, was likely to be awarded on a time-limited basis only, similar to APMS contracts, which are awarded for a five or ten-year period then put out to competitive tender.

In guidance to LMCs, the GPC said there was uncertainty around 'how contracts for core general practice services will fit into the new models and, indeed, whether it will be possible for GPs to maintain a ring-fenced budget for core work'.

The new contract being developed by NHS England for multispecialty community providers (MCPs) - which will see GPs taking on secondary care services - is likely to be 'quite basic', and there will be a lot of flexibility for local areas. 

’All of these developments have potentially far-reaching implications for GP contracting and service delivery.’

The GPC also warns thatit was 'likely that LMCs and GPs will be asked to consider moving en masse to new arrangements’.

'This could include proposals to move away from GMS and PMS contracting arrangements to new local probably time-limited APMS contracts.’

The GPC said its preferred outcome for the new models of care would be if 'core GMS or PMS contracts could remain separate from wider population-based contracts for other health services, with the contract held directly with the commissioner’.

GPC deputy chair Dr Richard Vautrey said: 'There's no doubt that the Government and NHS England plan to roll out new models of care using time-limited APMS-type contracts. Practices need to think long and hard before giving up their current GMS or PMS contract to join in these new arrangements as whatever promises they are given about a supposed return ticket, or short term promises about additional funding, this is undoubtedly a one-way street to larger organisations employing and directly managing GPs.'

He said the new situation was 'not like PMS practices reverting to GMS' because new models of care would be 'radically different' from the current contract.

He said: 'New models of care would be radically different and threaten to undermine the long-term commitment that GPs in GMS and PMS practices make to their local community. Instead NHS England should make a clear commitment to building wider community engagement and building comprehensive primary healthcare teams on the foundation of the current GMS and PMS contract not instead of them.'

However, an NHS England spokesperson said: 'The work is ongoing, [and] we’re very clear that nothing on this issue has been decided on.’

A recent Pulse survey noted that just 12% of GPs would consider taking on the new voluntary contract but the Department of Health has mandated NHS England to ensure half of England’s population is covered by new care models by 2020.

Readers' comments (19)

  • This will just kill off partnerships. NHSE is going to have to buy a lot of new premises to house all these short term salaried services. I suspect a whole host of GPs will be off to Oz and Canada soon where this dross doesnt exist

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  • ...and it will be pushed through, no matter what anyone says....J.Hunt is truely the Ultimate Terminator who does not feel pain , or fear or remorse and he Absolutely cannot be reasoned or bargained with!

    Truely the 'Hunter has become the Hunted'...how exciting and really, really Interesting !

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  • How can GPC publish guidance on a contract which is not even finalised?

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  • Premises are vital to this. If guaranteed funding isn't present then who is going to sign a lease? Apart from morons that is.

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  • Compulsary purchase of premises as I'm going to sell my building to the highest bidder once my contract goes back!

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  • To 6.05 the GPC can say this because a monkey could work it out.
    Check your partnership agreements and see what your options are for resigning. Often agreements include rules to prevent a mass exodus so the wise might wish to get their letters in early.
    Anyone thinking they will profit from their premises/lease etc will probably be disappointed. This issue is on a scale that would justify its own speciific legislation. Even though practices are private businesses, we are not allowed to sell goodwill so I wouldn't be at all suprised if there were compulsory purchases/lease takeovers which were limited to the district valuer's valuation. There will be no cashcow as it would be simply unaffordable. I would be more worried about holding a lease for premises that they would not wish to take over.

    Ditch the contract comrades!
    (and don't sign this new one either however tempting they make it to start with)

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  • |Anonymous | Work for health provider|18 Jan 2016 6:05pm

    "How can GPC publish guidance on a contract which is not even finalised?"

    Please do read the guidance before commenting. It sets out the list of suggested queastions in key areas for LMCs and providers to be asking now.

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  • Vinci Ho

    One thing we have seen locally in the region was a private company throwing back APMS contracts covering numerous practices(10 altogether) to CCGs as it could not make the profit it set out to gain in the first place when it won the tendering bid a few years ago.
    One thing Cameron et al. is very good at was declaring extra money for a politically correct agenda and extracting political capital immediately before anything happens realistically .
    The terms and conditions of this new voluntary contract will be easily favouring the best interests of Tories, at least in short term. The best interests of our patients? Nah!!

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  • Vinci Ho

    Correction
    (more than 10 altogether)

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  • The issue is not private vs state as general practice is already privately run. The difference is the scale i.e. small business vs limited liability large corporations. These beasts behave in very different ways especially when a large corporation becomes a monopoly provider.

    Step 1. Form federations.
    Step 2. allow federations to fail.
    Step 3. Absorb federated GPs into large private providers.
    Step 4. Large providers pull out as it is unsustainable to provide services
    Step 5. Explain to the public that the NHS is unsustainable.
    Step 6. Introduce insurance based system.

    This plan was hatched in Thatcher's era and has been in development ever since. We are now entering the steep part of the exponential curve towards the final goal. Once the trade agreements with the US are all agreed then they will have the green light for step 6. They already have Simon Stevens in post and his CV has mass corporate privatisation written all over it.
    Let them do it. They will still need doctors to work for them so what is the worry? Anyway, it will be such a vote loser that Corbyn who has been portrayed as a no hoper might emerge to be the heroic Robin Hood who brought back the NHS.
    What an own goal for the Tories!

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