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At the heart of general practice since 1960

Short-term GP contracts discontinued 'because patients want continuity of care'

A CCG has taken the decision to disperse patients to GP practices with long-term contracts rather than renewing three APMS contracts.

NHS Bradford City CCG said its decision, which will be implemented when the three contracts expire in March next year, was based on a patient consultation, which showed they preferred their GP services offered by a long-term provider with which they could find continuity of care.

The CCG is planning to offer the remaining 15 GP practices, a majority of which operate under PMS contracts, which are all within a one-mile radius the opportunity to take on the patients.

A CCG bulletin said: 'People who took part in the consultation said that they wanted to see the same GP team to increase their continuity of care and that changing the service provider every few years did not help with this.'

It said the decision was also 'based on staff views and opinions, a review of the patient lists of each practice, the health needs of the local population, the geographic spread of patients within the area, and the condition and facilities available at each of the surgery buildings'.

The CCG said the decision would 'see existing surgeries with long-term contracts taking on additional patients, improving their ability to recruit and retain key staff and enabling them to consider offering a broader range of services to the community'.

It added that the premises used by the three surgeries 'will be available to existing practices to use, if they require, in order to expand the long-term capacity of practices in the area'.

NHS Bradford City CCG chief officer Helen Hirst said: 'We think this is the best way forward for patients, who have told us quite clearly that they value continuity of care from the same group of doctors and staff.

'Allowing existing, high-performing surgeries to take on more patients will make them more attractive to clinical staff seeking employment, helping them to recruit and retain the right people to ensure continuity of care.'

Asked whether the practices, which are all based in the Manningham area of Bradford, had the capacity to take on the added workload, the CCG told Pulse that all of the practices currently have open lists accepting new patients.

The news comes as NHS England's national policy is to favour APMS contracts over GMS and PMS contracts, because they offer more 'flexibility'.

This has prompted the BMA's GP Committee to warn GPs not to hand back their contracts because it would throw them open to competitive tender and 'privatisation'.

A Pulse investigation recently revealed that not a single new GMS contract has been awarded by NHS England in five years. During the same time period, just one PMS contract was issued, while the remaining 242 new contracts were time-limited APMS contracts.

Asked to comment on NHS Bradford City CCG's decision to focus on longer-term GP contracts instead, an NHS England spokesperson said: 'NHS Bradford City CCG, as a CCG with fully delegated primary care commissioning responsibilities, has explored all the options available to them on the future of GP services in the Manningham area, with a decision based on robust engagement with patients, stakeholders and the local community, to provide continuity of high-quality GP services in the area.'

GPC contracts and regulations lead Dr Robert Morley said: 'It is good news that the CCG is taking patients' views on board. Patients want a traditional model of care rather than short-term commercial contracts.

'It is a great pity that NHS England and the Government don’t see this. I hope they pay attention. Commercial general practice contracts have been an unmitigated disaster for GPs and patients since they were brought in.'

Local Care Direct, a provider holding one of the APMS contracts due to end, said: 'It’s too early to say exactly how the closure will be implemented but we have asked for an urgent meeting with Bradford City CCG to discuss the implications of the decision.

'We will be doing whatever we can to support patients and our fantastic practice team to get the best possible outcome.'

Pulse has unsuccessfully approached Picton, which is the provider holding the other two APMS contracts.

Readers' comments (8)

  • The DOH has lost the confidence of the nation's GPs. Due to the hostile attitude of NHE towards General Practice, no sane young GP would commit to becoming a partner.

    The only thing that might save the traditional GP model, would be if the Government gauranteed to underwrite the debts of the 'Last man Standing'. It would have to be a legally binding guarantee, as due to the MPIG debacle no one would trust them otherwise.

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  • "preferred their GP services provided by a long-term provider with which they could find continuity of care."
    So why not be brave enough to commission a new one contract.
    Will need a massive golden hello, but will be cheaper than apps in the long term.

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  • "Asked whether the practices, which are all based in the Manningham area of Bradford, had the capacity to take on the added workload, the CCG told Pulse that all of the practices currently have open lists accepting new patients"

    Wow, if this was their assessment of capacity, it shows remarkable lack of intelligence. I'm surprised Bradford's GPs are not asking if their CCG is capabale of commissioning on their behalf!

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  • Just Your Average Joe

    Maybe this is the first seed of change away from privatisation!

    Think we should applaud a decision to stop the proliferation of APMS and private contracts.

    Just ensure the appropriate funding follows the patients to allow quality to remain, rather than cost saving measures to be attached to this decision.

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  • Dear All,
    Or perhaps it is because they will be paying GMS / PMS capitation rates rather than APMS rates?

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  • "Asked whether the practices, which are all based in the Manningham area of Bradford, had the capacity to take on the added workload, the CCG told Pulse that all of the practices currently have open lists accepting new patients"

    According to NHS Digital Bradford City has 127,000 registered patients and 48 FTE GPs excluding registrars and locums, but presumably including the GPs employed in the APMS providers.

    Even if all the APMS GPs are redeployed in the PMS/GMS practices, this would mean an average list size of 2,646 per FTE GP including salaried GPs.

    Lose just 5 FTE GPs from the three APMS providers that are closed and the average list size jumps to almost 3,000 pts per FTE GP.

    In the last detailed stats 3 Bradford GPs were aged over 70, 2 aged 65-69 and 2 aged 60-64. I would suggest that it wouldn't take a huge surge in workload for these individuals to leave.

    Contagion is an issue with a cascade effect from closures. If the dominoes start to tumble, it is very difficult to put it right.

    Protect and value what you have, don't roll the dice without weighing up the risks/benefits. Have a contingency plan. Be open about it.

    Relying on lists being open is not a plan, it is reckless.

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  • The fact that patients value continuity of care above all else will come as no surprise to anyone!! ( except the government!!)
    The assumption that the gms and pms practices locally will take on such a huge load of new patients and this will ' enable them to be in a stronger position financially to recruit' is a misguided falicy.
    It is at least a positive thing that continuity of care is being recognised and short term ism has been found to be lacking.

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  • The apms doctors will move to the other practices .
    We need partners who care and give individual care. That helps heal.
    Good to hear some NHSe have some sense ..not in the south.

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