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GP voluntary contract set for 15-year terms and may cover indemnity costs

Exclusive The new voluntary GP contract is set to be on 15-year terms and could include provisions for GP indemnity costs to be paid and an end to CQC inspections at a practice level, according to a GP leader close to the negotiations. 

Manchester LMC chief executive Dr Tracey Vell told the Health + Care conference in London today that the new contract - announced by Prime Minister David Cameron in October last year - will allow GP practices to join up to varying levels, including keeping their core GMS contract.

In Manchester, the LMC is negotiating the local variation - which is set to be close to the national contract - and may include allowing partners to have their estates bought out via a public-private partnerships.

The new national contract will be published at the end of September for rollout in April 2017, and will be flexible for local needs. 

As Pulse has reported, it expected that Manchester will be first to adopt the new voluntary contract for practices with populations of 30,000 and above, and many of the elements of the Manchester version will be applied nationwide. 

Seeking to allay fears over the new contract, Dr Vell said she was involved in the national negotiations and it was 'not so threatening as you think'

She added: 'I am not stupid enough to enter into something with all my colleagues behind me if I have not seen the contract, so that is why I am working with the national team to make the contract. We have not seen it, because they haven’t made it yet. That in itself brings some threats but it also brings some potential gains, that we can influence it.'

The national contract will be open to GP federations and the new models of care outlined in NHS England's Five Year Forward View - multispecialty community providers (MCPs); primary acute systems (PACs); and accountable care organisations (ACOs) - and will require organisations to offer primary and secondary care services. 

It will also involve the organisations offering routine seven-day GP services.

Under the Manchester model, there will be ten ACOs - large organisations that will encompass practices and secondary care organisations - which will hold the 15-year contracts and will allow practices to continue on their own contracts, Dr Vell said.

Deals that are being worked out specially for GPs in Manchester include:

  • Having their estate bought out via a public-private partnership;
  • Having their lease responsibilities taken over by the wider ACO;
  • Having their indemnity covered entirely by the ACO;
  • Not having to deal with CQC on a practice level.

On the specific terms being worked out in Manchester, Dr Vell said: 'You can have a buy-out of your estate. This is what we are doing in GM. GPs want to be bought out of private estate or leases. We are doing that, or making that possible..

She also said the new model would lessen the burden of regulation: 'We regulate the whole population hub at a cost borne by the organisation, the provider organisation, and we do it in that sense which makes more sense to everybody rather than the small business style approach, a very expensive approach for CQC and very expensive for practices.'

Under the plans being worked out, the LMC is looking at indemnity costs, she said.

Dr Vell added: 'We are negotiating a better deal for indemnity that will be a joint between hospital system and corporate indemnity so that we have an indemnified population hub, which means it is cheaper for every named GP in that corporate organisation.

 'We are hoping to remove indemnity from the cost of the GP entirely. That is the plan.'

Readers' comments (19)

  • Having no CQC in my life is attractive. But not so attractive I will put my head in the noose of this new contract. GMS all day long. Have we not learned the lessons of PMS?

    Besides if I want a CQC free zone, I'm thinking Scotland.

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  • Interesting non information as always by the local elite
    Are the proposed deals for Manchester still to be negotiated or are they in the contract that no one has seen or even written. What are the lines of accountability for practices with regards to the new ACOs
    Do we believe we are going to get indemnity , bought out of estates, no practice level CQC without ending up as a salaried service , losing practice identity and being performance managed by secondary care boards.
    It is shameful that providers are dictating to the acquiescent commissioners as to how this is going to work.

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  • Looks like all GPs are going to be salaried in the future.

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  • good to know that Privatisation through the back and increasingly front door will continue whatever the political climate...
    and frankly I want to pay my indemnity so that in a crisis it is me they are working for -

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  • Vinci Ho

    Isn't it ironic while Brexit is fundamentally about breaking away from a giant establishment , we are looking at bigger the better in general practice ? The 'sin' of a oversized , complacent and corrupt establishment is well documented and that is certainly one of the arguments of Brexit but I am also not that naive ignoring the reality . That's probably why I was such an idiot flipping a coin to determine fate.
    Of course , it is premature to make a judgement without further details of this new 'contract deal' but it is also well predictable by what had been laid down by Harvey Dent as far as the concept of MCP or PACS is concerned. Covering for indemnity is a natural if you work for a big establishment but fixing terms for 15 years is not quite like fixing your mortgage interest rate(although it may not be a bad idea if you are a first time buyer right now). Things are to change fast and furious in next 12 to 18 months and it is understandable that people do not like uncertainty. At the end of the day , if one is already in a dire situation , the temptation to join the 'club' is difficult to resist. But then , the lyrics in my most favourite song kept ringing ,
    ''Last thing I remember, I was
    Running for the door
    I had to find the passage back
    To the place I was before
    "Relax, " said the night man,
    "We are programmed to receive.
    You can check-out any time you like,
    But you can never leave! "

    Took me a whole week to see through the implications of this Brexit. We clearly had exercised an act of direct democracy ,although one can argue the difference between Remain and Leave was only about 4% and the discrepancies are vast amongst different sections of the whole UK . The result was considered as a 'surprise' by some but is it really? The truth was many people felt our national identity was well diluted by EU through the idea of free movement , hence the issue of immigration. The financial crisis provided an economic downturn as well as a catalyst of this feeling . A government positioning itself around the middle ground (what DC was insisting during the general election) could never answer this question about identity. If Labour failed the last general election trying to stay in the middle to the left , DC had failed by staying in the middle during this referendum storm in addition to totally inappropriate tactics(Populism is a double edge sword depending how 'properly' people are educated ).You thought you knew your position but the momentum of the storm actually drifted you further toward an extreme.
    But has nationalism actually won by Brexit? I think the post referendum government must be very careful to handle this . As I said before , in a critical time of history , a government has the responsibility to ensure extreme right (as well as left) ideology is not creeping back into the mainstream. Indeed , the immediate reflex and appalling discriminatory behaviour of some far right extremists on the street must not be ignored by the next PM and government.
    I do believe even though Brexit is to send us to a new dimension of reality(but we are also in the middle of a virtual Third World War),the government cannot abandon the middle ground politics as the country is already well divided enough. That is probably the momentum of these resigned Labour MP(many are Blairites)are trying to build restoring a leader of middle ground politics. Whether they can arrive at a 'position' remains unknown .
    The likelihood of an early general election (ironically people will then revert back to indirect democracy)is imminent and it is very difficult to know what ideology each party can actually sell.
    GP partnership model in NHS has offered us a position to see the good and bad of either end of the political spectrum but this position is always at risk of being drifted one way or the other by the momentum of any political storm in Westminster.
    Writing this comment while I am currently on annual leave in America. Question coming up in my mind: are we really seriously wanting to change our nation into a fundamentally right-winged country??

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  • who says that gps want to be bought out. I want to own my building and not have to ask for permission to use it at weekends and change the light bulb. I remain in charge of my environment and I like that. In addition when Ive paid off I will receive rent which is significant remuneration. If we are bought out I very much doubt we will get anything like we paid for it leaving a lot of recent buy ins significantly out of pocket. Isuspect that these will be in the minority: so that's alright then !!

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  • Agreed why would we want to be bought out, the best investment in your working life as a GP is the property you own without it retirement will be on a lesser pension and then no property payout either. looks like fools gold to me but hey the younger generation may prefer working for someone else and having the freedom that brings.

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  • also agree - been through a buy out before, and lost a significant amount of future income in exchange for a pretty building which was stiflingly hot in the summer and a room only big enough for me and the patient. Not interested. I'll keep doing 5 days a week and pay my own MPS fees thanks.

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  • I would rather own my building, pay my own indemnity and CQC fees. I am happy to bear the costs of these rather than become salaried, merge with other local practices, work towards pointless KPI targets and work 7 days a week. As a grass root Manchester GP, I do not feel Tracey Vell represents the view of the vast majority of my colleagues in Manchester.

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  • Please put your head in this guillotine and I promise I won't pull this lever over here which is way out of your reach.....mate

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