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Independents' Day

GPs miss out on £85m sexual health contract

Exclusive GPs have lost out on an £85 million contract to provide sexual health services in one part of the country, and will instead have to subcontract services from a ‘lead provider’.

Birmingham City Council has shortlisted providers for a new sexual health service, which combines all existing contracts – including general and specialist GUM services, STI screening and former GP local enhanced services – into a single five year contract.

The contract winner will act as ‘lead provider’ and Birmingham City Council intends for them to work with practices, as well as pharmacies and hospitals, to deliver sexual health services in future.

The council confirmed that no GP organisation had made it onto the shortlist, meaning the contract will likely be held by a local foundation trust or a private provider, local leaders warned.

GP leaders said this form of contract was a ‘world of difference’ from the current provision for patient lists.

John Denley, commissioning lead for sexual health services at Birmingham County Council told Pulse that the benefits of commissioning all sexual health services through a single, lead provider were ‘easy to establish’.

He added that GPs had a good track record in delivering sexual health services, but hoped the lead provider would find ‘more opportunities to deliver services in general practice.’

The council hopes the eventual contract winner would help to shift more sexual health services from secondary care into general practice.

Mr Denley said: ‘It’s a competitive bidding process, it’s not a “fill your boots up to £85m” it’s about the best quality bid, at the best price.’

‘We are lumping it all together, it is going to be a single system and the benefits of a single system are easy to establish. We had so many different contracts, 20 plus contracts, and around 90 contracts with general practices in Birmingham to deliver sexual health services. Each of those contracts were in singularity, so there was no way of the systems talking to each other.’

He added a single provider would help to standardise service quality, saying: ‘There’s such a variation in quality across general practices, what we want a lead provider to do is get a grip on that, make sure we’re all working to the same quality.’

‘So patients and clients of the sexual health system in Birmingham will experience the same standard of care, at the highest quality, right across the board.’

But Dr Robert Morley, executive secretary of Birmingham LMC and chair of the GPC’s contracts and regulation subcommittee, has warned that there’s a ‘world of difference’ between being subcontracted to a third party, and the way these services had historically been delivered.

Dr Morley told Pulse: ‘[I understand the council] are seeking the contractor to enter into some sort of sub-contracting arrangement with GP practices, so that work can still be delivered through GP practices.’

‘Which is encouraging in a way, but there’s a world of difference between that and the historical situation where-by general practice has provided this work holistically to its registered patient list.’

‘We don’t know what the new arrangement is going to be like, it depends which organisation wins the contract, and clearly with something this size only a very, very large organisation is going to be in a position to bid in the first place.’

‘I imagine the favourites will be either large foundation trusts or very large commercial entities.’

And Dr Morley confirmed that the local GP practices that there hadn’t been a successful GP-led bid to be the contract provider, but said he was ‘hopeful’ that GPs might have some influence.

He told Pulse: ‘Sadly what has happened is they, and the GP-body as a whole, hasn’t been able to get their act together to have the single sort of bid.’

‘There’s a possibility, and certainly there was an attempt to get a single, GP-led bid off the ground. But because of different groupings of practices in co-ops, and so on, it hasn’t been possible to get a united GP-led bid.’

‘Which means that inevitably the successful bidder will not be a GP led organisation, though I’m hopeful there might be some GP influence with it.’

Competitive tendering for services has become a major concern for practices and GP leaders, who believed it could ‘destabilise’ practices and the professional bodies even warned competition could ‘reduce’ patient choice.

However Pulse has recently revealed that practices have been granted a reprieve in many cases, with a third of CCGs saying they would review services this year before making final decisions on whether to use competition.

Several regions are using that time to form GP federations or provider companies, and Pulse survey earlier this year revealed that a fifth of practices were contemplating some form of GP alliance after fears that single-handed practices would lose services to large private providers.

Readers' comments (17)

  • Isn't there a federation in Birmingham called BADGER? Would seem perfect for them to pick up IF they wanted it!

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  • Do those blaming the current government really believe this to be a party specific issue? Is a Labour government really going to wave a magic wand and sort it all?
    The NHS crisis is partly due to the funding crisis necessitated by macroeconomics but largely due to the failure of successive governments and the profession to articulate reality. We cannot go on pretending that everyone can have what they want, when they want it, at the expense of those that really need.

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  • Bob Hodges

    Increasingly politics and voting is becoming a choice between stupid + naively optimisitic and stupid +nasty (the Tories being the latter choice).

    Call me old fashioned, but if we're going to hell in a handcart either way, I'll rather go there with a bit of soul.

    Billy Bragg or Simon Cowell?

    Perhaps I'm just a Punk at heart.

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  • Vinci Ho

    Representative politics:
    In this system of the western world , all elected government and its ministers represent People. You can argue democracy only exists near time of election but evaporates immediately after that.
    Like others , we , medical professionals are people as well and do not have this political authority to represent people.Hence, we are always receptive.
    If ministers from any party or any government are not honest to admit what they can and cannot deliver, only people will suffer. The common practice is to find scapegoats to be blamed when things went wrong simply because things cannot be achieved due to lack of committment and investment from these ministers. Being not realistic is because they have to promise and promise.Of course , they will deny that lest they would lose votes.
    However, people have the right to 'check' a government to ensure it does not cause 'harm'.......

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  • Whether there is anything they don't do will depend on how good the service specs are and the contract is.

    Since Sexual Health (except HIV management) is Council/Public Health run now we dont necessarily have any influence over it.

    Of course just because they have a contarct to engage doesn't mena to say GPs have to.

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  • Hello Anon at 11.32 - Fay here.
    BADGER sadly didn't manage to persuade all the local NHS providers to work together in an irresistible consortium but anyone who knows us knows we are are virtuous, visionary and versatile, so we've adapted to circumstances and implanted ourselves under the skin of the biggest FT in town. Don't tell anyone - it's a secret :-)

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  • At £85m this contract sounds like its out of the reach of most organisations to act as 'lead contractor' ut i do wish the media would stop painting GPs as the poor infortunates. If they bid and didn't win its because they either didn't sell themselves or they actually can't deliver the requirements. That's nothing to be ashamed of though. GPs should look at this from the patient's perspective and the benefits that could be gained from shared resources and economies of scale. Speaking from personal experience id rather get an appointment at a clinic quickly which serves a number of practices than have to wait over 8 weeks because my own surgery only has one GP that can deliver IUCD fitting and she's too busy being a GP to fit me in!!

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