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The waiting game

GPC challenges decision to open all new GP contracts to competition after legal advice

Exclusive The BMA will write to NHS England calling on them to reverse its decision to only procure new GP contracts using APMS contracts following advice from its lawyers, Pulse can reveal.

The GPC will send a letter to NHS England (London) area team - which was the first area team to publicly announce it was introducing the policy - stating that new contracts should be GMS or PMS, and that NHS England’s stance to only award APMS contracts ‘does not accord with current procurement regulations’.

The letter, which was written following advice taken from the BMA’s legal team, will call on NHS England to reverse its policy, which GPC chair Dr Chaand Nagpaul - writing in Pulse today - warns will ‘destroy the fabric and ethos’ of general practice.

This comes after Pulse revealed that NHS England had called a halt on handing out GMS and PMS contracts, arguing that only APMS contracts comply with procurement law by allowing non-GP providers to compete.

The policy has provoked concern among GP leaders, particularly after Pulse’s Stop Practice Closures campaign found more than a hundred practices who were considering giving up their contracts.

Some have predicted that these closures will lead to a widening of privatisation of practices, as under NHS England’s policy the contracts for these practices would then be reprocured under APMS arrangements.

As a result, GP leaders have urged practices to consider mergers to preserve their GMS or PMS arrangements where there is a risk they may go under.

When Pulse first revealed that NHS England had adopted this stance, the BMA took urgent legal advice and have subsequently identified two areas that they believe exempt GMS and PMS contracts from competitive processes.

Dr Nagpaul writes: ‘NHS procurement regulations, as well as guidance from Monitor, clearly allows flexibility on whether to choose open competition, taking into consideration “securing the needs of patients”, as well as “value for money”.

He explains that APMS contracts don’t satisfy these considerations as they are typically only issued for a five-year period, subject to renewal, and must be procured through costly tendering process.

‘It is unarguable that patients’ best interests are served by secure, long-term dependable local GP services,’ he says.

Dr Nagpaul adds: ‘[Patients] would be appalled to learn of a policy to replace their local GP surgery with a five-year service run by another organisation.’

‘Neither does APMS tick the value for money box. [In recent years] many costly APMS contracts, paid much more per head than GMS or PMS practices, have been decommissioned due to not being cost-effective, or not having delivered on their contract.’

He adds: ‘We will be writing formally to NHS England (London) to withdraw this blanket policy that undermines patient care, and which we believe does not accord with current procurement regulations.’

NHS England (London) area team told Pulse: ‘To allow for greater flexibility of provider, and to comply with international procurement law, APMS contracts are the only contracts that NHS England can offer new or replacement practices.’

‘They are the only contracts that allow for those other than GP practices to bid for the practices.’

NHS England told Pulse: ‘Under the GMS regulations there is scope to enter into a temporary contract but this is at clear odds with procurement law and the 2013 regulations so best practice would dictate that this should not be used when APMS effectively does the same job and does not come with the same risks attached.’

‘GMS can still be entered into upon reversion from PMS and a the new form of PMS contract may be entered into by way of renegotiation (ie variation) but in respect of procurements, yes they should all be on APMS.’

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  • Chaand Nagpaul   - online
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Readers' comments (19)

  • The BMA will write to NHS England calling on them to reverse its decision to only procure new GP contracts using APMS contracts following advice from its lawyers
    and what if NHS England just ignores this?

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  • The agenda for privatisation is set - nothing will change it without a change of government .

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  • > what if NHS England just ignores this?

    Well then the BMA will be jolly upset about it and and will generate some gentle PDF posters that a handful of surgeries can put up.

    They will also call up their confectionery department and get them to increase the proportion of cocoa in their chocolate teapots.

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  • When will we as doctors stand up to the govt and say enough is enough and for example go to 10 downing streeet and not leave until we are listened to ! too much rhetoric and no action

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  • If GMS funding really is not sufficient then the tendering process involved in APMS will show that.

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  • If GMS funding really is not sufficient then the tendering process involved in APMS will show that

    Its already been demonstrated time and time again how non-viable APMS is. However the reason it is being pushed is for ideological reasons and pure dogma from the right wing political class.

    The facts that fewer people are entering the market for APMS unless it is funded at 4-6 times GMS rates tells us everything.

    The GPC need to follow this through - it may fail as it will depend on interpretation of law - but then it does crystallize the issues for the politicians

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  • Vinci Ho

    What is the origin of evil?
    It is called Sec 75. I can understand GPC is trying to bring on arguments WITHIN the boundary of legislation(probably why it consulted legal advisors).
    But this should be a protest against an evil legislation and a campaign to overturn this act which is to destroy NHS, a 'property' of people in this country:

    The reason why men enter into society is the preservation of their property, and the end why they choose and authorize a legislative is that there may be laws made, and rules set, as guards and fences to the properties of all the members of the society, to limit the power and moderate the dominion of every part and member of the society. For since it can never be supposed to be the will of the society that the legislative should have a power to destroy that which everyone designs to secure by entering into society, and for which the people submitted themselves to legislators of their own making, whenever the legislators endeavor to take away and destroy the property of the people, or to reduce them to slavery under arbitrary power, they put themselves into a state of war with the people, who are thereupon absolved from any farther obedience and are left to the common refuge, which God hath provided for all men, against force and violence. Whensoever therefore the legislative shall transgress this fundamental rule of society, and either by ambition, fear, folly or corruption, endeavor to grasp themselves, or put into the hands of any other, an absolute power over the lives, liberties, and estates of the people; by this breach of trust they forfeit the power the people had put into their hands for quite contrary ends, and it devolves to the people, who have a right to resume their original liberty, and, by the establishment of a new legislative, (such as they shall think fit) provide for their own safety and security, which is the end for which they are in society........
    John Locke, Second Treatise on Government , 1689.
    (Sorry, editor , keep quoting this lately)

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  • GPs have only got themselves to blame for this. They have allowed the "yes men" of the profession from the NAPC and NHS Alliance to saddle up with the DH. Dixon, Alessi, Marshall, Field, Kingsland et al were instrumental in helping the Health and Social Care Act reach Royal Assent. And they have been rewarded nicely with plum jobs. These organisations represent a tiny proportion of GPs compared to the BMA and RCGP, yet grassroots GPs did nothing to oppose them and hold them to account.
    General Practice is falling apart and the privatisation procession rolls on.
    Why on earth do GPs put up with these unelected "yes men"? Isn't it time for you to call them to account and demand new leaders in NHS Clinical Commissioners?
    Why not get a vote of no confidence up and running?

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  • Vinci Ho

    Totally agreed

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  • Vinci Ho

    * *Do remember that dishonesty and cowardice always have to be paid for.*Don’t imagine that for years on end you can make yourself the boot-licking propagandist of the Soviet régime, or any other régime, and then suddenly return to mental decency. Once a ***** always a *****
    George Orwell

    1/9/1944 Tribune
    (Sorry , George, have to block the word, or else the editor will moderate this comment)

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