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GPC advises practices 'not to feel pressured' to sign up to voluntary contract

The GPC has advised GP practices to be wary regarding relinquishing their national GMS or PMS contract in favour of the new voluntary contract being developed by NHS England.

It said practices should ‘not feel pressured to make any hasty decisions at this stage’ and should work with LMCs to propose how they should participate in the 'multispecialty community providers' (MCPs) while retaining their current contract.

The GPC published its advice in response to NHS England’s MCP contract briefing published last month, which gives the first indication on how the new models of care - the organisations that will provide primary and secondary care - will be paid. 

The advice said: ‘We have consistently argued that participation in, and the success of MCPs does not logically depend on practices moving away from their standard contract, since the wider integrated delivery of services sits above the core contractual responsibility of practices.'

There are three levels of the new voluntary contract: a loose alliance type contract, where practices will retain their GMS/PMS contract and provide certain services; a ‘partially integrated’ MCP contract, where GPs retain their GMS contract alongside the MCP contract; and a fully integrated contract, where GPs give up their GMS/PMS contract.

Specifically, the GPC has concerns that the ‘fully integrated’ MCP contract model described in NHS England’s plan would lead to a watering down of the nationally-negotiated GMS contract in the long term.

This model would see GP practices enter into time-limited 10-15-year deals under which they will provide primary, community and some secondary services and enter into a 'gain/risk share' for acute activity, meaning they could lose money if they don't cut down on admissions. 

Practices who sign up to this will see their GMS or PMS contract 'suspended' during the MCP contractual period, but they will have a right of return to the national contract.

In reality, the GPC warned, extricating a GP practice from the MCP model was ‘likely to be far less straightforward’.

The GPC advice said: ‘It is vital that NHS England has recognised this is one of three MCP type models. Whilst the MCP contract is currently aimed at being voluntary and, in the short term will only affect practices within the area of one of the six MCP pilot sites, there exists the possibility now or in the future that practices may feel pressured into signing up, either by commissioners or as other practices in the area have already done so.

‘If your practice does feel uncomfortable with proposals being put to them, you should contact their LMC or the BMA for advice. GPC will be producing further guidance once details of the full MCP contract are confirmed.’

NHS England is expected to publish the full MCP contract framework by the end of September.

Readers' comments (6)

  • In Manchester there has been talk about tipping points for practices to switch to the voluntary MCP. A CCG chief exec has said that QOF and LES funds would be at risk for practices that don't sign up. Unfortunately the last place we can goto is Manchester LMC for help as the hierarchy is leading the national and local process.

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  • to join a MCP I would need to be offered a guarantee of income that is way in excess of GMS core plus qof etc. That would start to look like PMS, which has been good for a few years but is now being stolen from us.
    Anon 7:54, you elect members to the LMC. If they are doing a poor job get yourself elected and help hold their feet to the fire.
    CCG = membership organisation. LMC = representative organisation.
    If you feel victimised by either you have the power to change things

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  • Yeah, Like GODFATHER, they will soon make us a offer we cannot refuse!!

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  • Salford also pushing forward with " voluntary" GP organisation I.e. go bankrupt or join . Then become salaried , then watch the whole secondary care led organisation blame primary care as it collapses.

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  • Typical GPC, desperate that we all hang on to the miserable contract they have negotiated for us where we hold responsibility to provide whatever our patients need for a fixed income, demand rises, costs rise, workforce decreases, our problem. result work 14 hours a day for an income lower than 10 years ago with no option to walk away or leave because as individuals we are responsible for leases and redundancy costs. young docs are not interested, older partners beware you are stuck with your partnerships and will be the last man standing. the option of handing that personal liability to a larger organisation and going back to being responsible for seeing patients as part of a larger team seems not only a logical choice but blooming obvious.... to all except the GPC but then what would they do if we all did that..... have to start doing the job rather than just talking about it maybe. ..

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  • Lets be clear the problem with the new offer is "you" take the gain/risk with the NHS to reduce acute admissions? Maybe as a GP you have been admitting patients to Hospital "nilly-willy" with no reason - but I say beware if the contract states cut-back on your admissions or get a financial penalty - what will be your choice be?

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