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Stevens: New GP contract may be unsuitable for rural practices

The Government’s new voluntary GP contract may not be suitable for rural practices, the NHS chief has said, leading to fears that it could create a ‘two-tier service’. 

NHS England chief executive Simon Stevens, taking questions via video link at the National Association of Primary Care’s Best Practice conference in Birmingham, told a practice manager at a rural practice that the new contract was unlikely to benefit all practices.

There are few details about the new contract, but NHS England has said it will be for practices or federations covering at least 30,000 patients, who will have to provide some sort of weekend and evening routine access.

However, there are fears that not all practices may be able to operate at this scale, which will lead to them losing out in the long run as more funding is given to larger organisations.

Kate Davenport, a practice manager in Bath and North East Somerset, said she had ‘a concern that the focus on working at scale potentially creates a new kind of division between urban and rural practices’.

She said: ‘We are as near urban as a rural practice can get, but we have 9,000 patients. The only other practice in our catchment area has 6,000 and we’ve looked and looked at models that make sense on a wider scale, and for us it just doesn’t.’

She added that there was a ‘risk that rural practices will lose out on the kind of opportunities this voluntary contract and all sorts of other working at scale type projects bring to general practice’, because working at that scale ‘doesn’t work for us’.

Mr Stevens responded: ‘No, and therefore it is not the right option for you. However, the mantra here is horses for courses. So if it that is not the right developmental path for expanding and strengthening primary care services where you are, then that’s fine, don’t do it. That is what the voluntary option means.’

In a grassroots GP debate following Mr Stevens’ call in to the conference, Dr Luke Evans, a GP in Birmingham and unsuccessful Conservative MP candidate for Birmingham Edgbaston in the 2015 general election, said he was also concerned some practices could be left behind.

He said: ‘On face value it looks quite good… but my worry is what happens to the people who decide not to take this on. If you’re a trailblazer, you can get 30-50,000 people together, it sounds fantastic. But what happens, as we’ve heard in one of the questions, if you can’t do that? If you’re left behind? Are we going to create a two-tier [general practice].’

What does the Government’s new GP contract mean for me?

Readers' comments (7)

  • basically covering back for when rural areas have no GPs - it will be 'unforseen circumstances' etc ...

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  • Vinci Ho

    Two tier
    Two faced
    Harvey Dent

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  • Does anyone think that the people who thought up the new contract were thinking in a London/city centric way and not thinking about the whole of the UK.Do these people actually have the capability of thought or are they as ignorant/callous as they seem to be. Vandalism in the extreme.

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  • So what "voluntary" contract is to be offered for those in rural areas to enable them to develop and provide the service needed by their patients? There needs to be a balance and range of options suitable for all practices rather than exclude those they presumably hadn't considered from their London base.

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  • I do not trust a word from simple Simon with his background of destruction fragmentation and waste due to his insane internal market
    Like the disgraceful *unt he should RESIGN

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  • nowhere in this rhetoric is there a mention of the value of continuity of care, a cornerstone of partnership-driven care in rural areas. It is not possible to have 7/7 8-8 access and continuity, and most sick patients would put continuity first!

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  • Not unsuitable for United Health - and that is key. A peerage is waiting in the wings once
    'The ship has weather'd every rack, the prize (you) sought is wonn '

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