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CAMHS won't see you now

Don't sign new contract from NHS England, GPC advises

Exclusive GP leaders are urging practices not to sign a new version of the GMS contract circulated by NHS managers to at least 300 practices, warning that a ‘cock-up’ over the wording prohibits practices from taking legal action against their local area team.

The contract circulated by the West Midlands local area team has excluded the option – recommended by GPC – for practices to sign as non-NHS bodies. The main consequence of signing this, GP leaders say, is that practices waive their right to challenge any contractual disputes via the courts.

The GPC is currently investigating if this is a regional or national matter and whether the wording was intentional or a mistake.

NHS England admitted that an ‘erroneous’ contract had been sent out to some practices and it was up to GPs themselves to check for the mistake.

In an update to practices, the LMC said: ‘The LMC and GPC advice to practices has always been to elect NOT to be an NHS body, as if the practice elects to be an NHS body it forgoes its right to opt to have contract disputes dealt with through the courts rather than solely through the NHS disputes procedure.

‘It’s unclear at present whether this errant version of the contract has been sent, or is intended to be sent, to Birmingham practices, but if you have or do receive it then the LMC would strongly advise you not to sign it and return it to your CCG, requesting a version of the contract which allows you to opt out of NHS body status. Your CCG contract manager has been copied in to this message.’

Birmingham LMC executive secretary and head of the GPC’s contracts and regulation subcommittee Dr Robert Morley said the documents had been circulated across the whole West Midlands, including in Birmingham, Black Country, Solihull, Coventry, Warwickshire, Worcestershire and Herefordshire, in the past weeks.

He told Pulse: ‘The NHS contract must give practices the choice of either opting to be an NHS body or opting not to be an NHS body and that is the wording that should be in the contract. Certainly some NHS England offices have sent a new contract out for practices to sign that doesn’t give them the option and simply obliges them to be an NHS body.

‘The relevance of this is that if you opt to be an NHS body then you are precluded from using the courts for any contract disputes, you must use the NHS disputes procedure. Whereas if you opt not to be an NHS body then you have the choice of going to the courts. That is the key issue and we have advised our practices that they must not sign this.’

Dr Morley said it was as yet unclear whether NHS England had made a mistake or was trying to change the contractual terms.

He said: ‘I am assuming that it is a cock-up but one does wonder whether someone is trying to slip this in through the backdoor, because it seems to be no coincidence that when a cock-up does happen it always seems to be in the direction of something that is more detrimental rather than beneficial to practices.’

The wording in the erroneous contract states that ‘[t]he Contractor has elected to be regarded as a health service body for the purposes of section 9 of the 2006 Act. Accordingly, this Contract is an NHS contract’.

However, the real contract gives signatories the opportunity to choose that ‘[t]he Contractor has [not] elected to be regarded as a health service body for the purposes of section 9 of the 2006 Act. Accordingly, this Contract is [not] an NHS contract’.

Acknowledging the error, NHS England said that for 114 practices in Birmingham, Solihull and the Black Country it had transferred over the existing NHS body status that was on their contract before reverting to GMS from PMS.

It said it ‘acknowledged’ this was ‘a decision that shouldn’t have been made on an assumption’ and said it would ‘work with any GP practice who want to amend their new GMS contracts via the contract variation process’.

Meanwhile, for 213 practices in the Coventry, Herefordshire, Worcestershire and Warwickshire, NHS England said it was ‘a simple admin error on the contract that in the default, did not give the option for practices to decide whether they want to be an NHS body’.

A spokesperson said: ‘Again, we have offered practices the opportunity to amend this.’

The spokesperson added: ‘NHS England would like to stress that the new GMS contracts were not purposely manipulated to ensure GP practices agree to terms that they are not happy with. We will continue to work transparently with all practices to ensure they are happy with their contractual arrangements and ultimately, be content in their role to continue to provide high-quality patient care.’

NHS England said that it was ‘requesting that all practices that have received a new contract check the content prior to signing and returning to us’.

Readers' comments (20)

  • No point sending a contract issued by NHSE back to a CCG unless they have full delegation, they can't do anything about it...

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  • So the Area Team have made a mistake and have offered to correct it.......not sure that is much of a story and the scaremongering does no credit to Pulse.

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  • @10:48: It does because the stupid clauses put in the Contracts 'by error' are far too many.
    They can go to the extent of NHS Managers/NHSE using old templates for Contracts as my experience has shown and putting clauses nonsenscial, whimsical and stupid to the extent that even after signing them, you can actually bury them in a Court. GPs should read through every line and not having time is not a good enough reason not to do so.

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  • @10:48 Actually, if an Area Team has made a mistake, is owning up to it and putting it right, that's a contender for story of the year! As a Practice Manager, I feel that Area Teams certainly don't give any room to practices who make (human) errors; on the contrary, Area Teams seem hell-bent on detroying the good will of general practice and making our lives as painful as possible.

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  • The problem today is that GP's want the money but don't appear to want to provide any service.

    I have always supported GP's but now feel they do other jobs as their main role and work as GP's as a side line.

    There are ten GP's at my practice but not one of them work full time, they all have second jobs.

    I now feel all GP's should be contracted to the NHS on a full time basis or have the number of patients on their books reduced according to the number of hours they are available to se patients.

    where else do you get paid to provide a service whether you are available to provide it or not!

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  • I do not believe for one minute that this was a mistake.
    I have never heard of this choice, from a contracting authority or the BMA and have never had this choice, it's pros and cons, explained to me.
    What it tells me is that NHSE are scared of being sued so....
    Anyone who has any reason to sue them should consider doing so now.

    We are simply not treated in the same way as any other workers. Enough.

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  • @ 11.59am

    Since when were doctors not permitted to work part-time? GPs working full-time are the ones more likely to be burning out. The job of GP is punishing these days, you hardly blame, a day off for R&R or change of scene keeps us sane.

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  • OHP@11.59 - Eh?
    (a) Don't see the relevance and
    (b) It is becoming impossible to do this job "full time" (ie 50-60 hours a week) - often part-time (which you'd need to define in terms of hours rather than general description given that standard full-time is around 40 hours a week) plus outside, less demanding, interests is a way to survive. Moreover
    (c) If a cap in list size is introduced, I suspect there'll soon be an awful lot of patients with no GP

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  • Shurleea Harding | Other healthcare professional | 21 August 2015 11:59am

    another ignorant post. We GPs are worth more money than we're given at the moment, don't believe me? wait til we're all gone. And its more of a question about we're not being paid for the services that we already do provide. Do you think we want to do 2nd jobs or other sidelines apart from proper patient contact? everything else has been foisted upon us by above e.g. QOF, appraisal, et al. You want us to work more hours seeing patients? Get your politicians to stop giving us this shite then. and in which other job do you not have the choice about the hours you want to work??? do GPs deserve less rights then? Plus as above, a cap on list size would mean less patients get seen rather than more.

    If you have no clue about what being a GP is like, leave your comments to yourself

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  • Vinci Ho

    Error ? Not error?
    It is called 'testing the temperature of the water', mate.
    Nobody spotted it , happy days!!
    Got ya! So say sorry to you guys, no big deal .NHSE is here to help , always, don't be so serious......

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  • Shurleea

    I find your post very sad. You have always been very pro GP and a voice standing up for treating us as human beings. You have shown that you understand the pressure we are under. What has happened?

    The honest truth is that the job is simply awful and doing it "full time" is impossible. The average working day is 12+ hours and 8 sessions is about 54 hours a week, plus extra at home.

    I tried part time ( 6 sessions, approximately 40 hours. A week) and found that I was simply expected to do everything I did before in less time and for less money.

    I have now stopped working altogether.

    If the ideas you suggest are adopted a large number of GPs will simply leave. Part time GPs are better than no GPs.

    Ex GP partner, ex trainer, now house CEO aged 55

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  • This is most assuredly not a mistake. Whilst with most things I prefer to believe in a cock-up rather than conspiracy, in this matter the NHSE predecessor, the PCT, did similar our end of the woods. It stopped at least one GP from taking the estates department to court.

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  • This comment has been moderated

  • Vinci Ho

    you see
    there is a fine line between idiot(cock-up) and evil(conspiracy)
    Believe what you believe

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  • @shurleen 11:59

    GPs work in other jobs mostly to keep them sane: try working 9-10 sessions a week and see how long your remain healthy:

    I was a GP partner aged 29 only a few short years ago: i was working 9 sessions in a busy practice plus pulling in another 3 sessions in out of hours; my senior colleagues (all of whom were above 50 years of age) thought i was insane. gradually the job became more and more stressful to the point where i gave up my 3 ooh sessions and took on other roles within the practice during my 9 sessions- one of these involved teaching medical students from a local university and also another setting up a diabetes clinic where i would commence insulin starts etc (a service we didnt provide at that time):

    most NON clinicians dont understand the duties a GP has, even though intellectually they are able to list them off; the pressure and workload in the ukmade me realise that for a better future my life and career lay abroad. having left england in 2012 i can tell you abroad in north america no one tells me how and when i should work, its accepted that WE as clinicians can choose our workload, life, hours and the type of patient we choose to work with...

    your post typifies all that is wrong with the uk--- what gives anyone the right to determine how a professional should work.... my worth is far in excess of what it was in england, the rest of the planet puts a premium on the skills of a doctor who has over 10years of training........

    you can keep your crappy contracts, your measley pay and your autocratic system....... many, many , many more doctors will be leaving i assure you with this type of attiutude thats rife in britian.....
    where else are people so highly skilled literally forced to work in suc demeaning conditions, without proper remuneration and literally endless work (a capitation contract to provide limitless work on a fixed income??????????)

    thanks for helping to pay for my training and providing me with skills to now do a real job and make some real dosh!!!

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  • It would be interesting to know what job does Shurleaa Harding do ? Does he/ she understand that doctors who work part time also get paid only for number of hours/ session they work for. So if their surgery if all doctors work part time and by dictating doctors hours of working if they make all doctors work full time practice would employ only half the current doctors . All of them will be under tremendous stress and soon get burn out. I have had experience of working in 4 different countries 1st world to third world) .No where i n the world doctors are treated so badly . Every Tom Dick & Harry wants to tell doctors how to do their job. I think time has come for all GP to leave NHS and then let market dictate doctors fee/ pay.

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  • @ Dr Bahalkar above

    youve hit the nail on the head: only in the UK are the population/ administrators/ bureaucrats/ media so arrogant that they feel they are entitled to dictate to you how you should practice. If these were just opinions without power it might just soften the blow, however in most cases this just isnt the case and the prejudices and falsely held beliefs that these people hold make a hard job unbearable........

    ..just look at the number of headlines saying "doctors should do this..... do referred to the GMC if they prescribe too many anitbiotics etc......

    it seems clear to me that everyone has an opinion of a job they are themselves unable to do!!

    one thing is for sure, the vice like grip these people have over you, is unlikley to be removed by the tormentors themselves! and in real life, power once lost is rarely given back....there are too many people out there whose livelehoods depend on demoninsing or managing doctors (sadly quite a few of them are doctors themselves) because its much easier to manage that tobe on the front line firefighting.

    my advice (and ive walked the walk here as an ex GP) is to extricate yourselves from this sadistic system that allows doctors to burn out, punishes whisleblowers and has led to the death of countless of our brave colleagues listed for the now infamous FTP hearings.....

    RLE if you can........dont waste your life slaving away for folk who really couldnt give a damn about you anyway

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  • Interestingly I've found a mental health promoter by the same name as an early poster by the name of shurleea Harding. Here's what's listed on a linked in summary.
    It tells me all I need to know about the credibility of someone questioning a GPs work ethic.

    "Having spent 60 years in the mental health system my aim is to tackle the stigma that surrounds mental health. There is a need for real change, and time psychiatrists woke up and started dealing with root causes, not just treating symptoms and handing our prescriptions.
    Anyone can be a psychiatrist, just buy the ICD10 and a copy of the BNF, that is all psychiatrists use.
    It is tim e psychiatrists made themselves available in the same way as GP's so that when a patient is troubled, the see a doctor not a CPN, after all, if CPN's can do their job, why do we need psychiatrists anyway?"

    if this by chance is the same person as the poster earlier it just goes to show how much ignorance there is in the public eye regarding doctors workload and it seems training!! I wasn't a psychiatry trainee but did a 6 month rotation in psychiatry as part of my VTS, if I knew that all the skills that were needed to become a psychiatrist were to read the ICD-10 workbook and the BNF I might have had a stab at the MRCPsych exam - those wretched psych trainees must have been lying when they told me how tough their exams were!! It's obvious we know who to believe and I recommend this poster be made head of the NHS.........because it's clear they know what they're talking about and will sort out all it's ills and make it the envy of the world once again..

    Thanks once again

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  • The area teams have been hung naked upside down

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  • down with the NHS lets just all be true independent practitioners once again. If the goverrnments wants to pay for care so be it. if not so be it.

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  • Don't trust those snakes.

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