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Independents' Day

LMC leader to chair Hunt review into 'reinvigorating' GP partnership model

The chief executive of Wessex LMC has been appointed chair of a major independent review of the partnership model to look into how it needs to evolve in the modern NHS.

Dr Nigel Watson, who is also a member of the BMA’s GP Committee and its former lead on commissioning, will oversee the review, which will report back to health and social care secretary Jeremy Hunt and NHS England chief executive Simon Stevens.

This comes as a Pulse survey of 420 GPs found that half of those who currently have partnership roles would consider giving them up to go salaried.

Mr Hunt first announced in Parliament in February that the Department of Health and Social Care was in talks with the BMA and the RCGP over a review of the model.

There is little detail about what the review will cover, and the Department of Health and Social Care has said talks are ongoing, but NHS England saif that it will 'help shape new options for future generations of family doctors'. 

Dr Watson has led GPs in the south of England for 14 years - he was previously described as an 'LMC legend', with Wessex LMC labelled 'the best LMC in the country' - and has been a long-time vocal member of the GPC.

He has also been leading attempts in Hampshire to open a 'multispecialty community provider', one of NHS England's 'new models of care' that will provide primary and secondary care.

Dr Watson said: ‘It is a great honour to chair the review and I plan to engage widely with organisations, as well as front line clinicians and practice staff, to identify the challenges and will make a number of recommendations about how the partnership model can work in the future.’

Health and social care secretary Jeremy Hunt said: ‘The GP partnership model has benefitted patients over the years but in an ever-evolving NHS environment we need to consider new ways to reinvigorate the current model.’

NHS England chief executive Simon Stevens added: ‘The great strength of British general practice has been its diversity and adaptability.

‘So in the year the NHS turns 70, this review will help shape new options for future generations of family doctors.’

GP leaders have previously warned that the profession will be staffed by salaried-only doctors in the future to the detriment of patients.

BMA GPC chair Dr Richard Vautrey said the GP partnership model 'is the foundation on which the rest of the NHS is built'.

He said: 'We know that our independent contractor status and GP partnership model are good for doctors, our staff, patients, communities and the wider NHS, but we also know that many practice partnerships are struggling to recruit new GPs as doctors raise increasing concerns about rising workload pressures, premises liabilities and indemnity risks.'

Dr Vautrey told Pulse earlier this year that there is ‘lots that we think can be done’ to modernise the partnership model, including providing flexibility for GPs working as partners.

‘That means keeping all that is best about the here and now, while also asking thoughtful questions about how the partnership clinical, business and career model might evolve for the future.’

This comes after Mr Stevens said in a hearing with the Lords committee in December last year that GPs were willing to consider ‘radical’ changes to their model of practise because they have been ‘systematically under-invested in’.

Meanwhile, shadow health secretary Jonathan Ashworth told GPs at Pulse Live in March that non-partnership models needed to secure future of general practice.

The Pulse survey asked GP partners whether they would consider going salaried 'if offered the right deal' with 50% saying yes, while 40% of respondents said no and the remainder said they didn't know.

This marks a marginal improvement compared with a Pulse survey carried out in 2016, when 51% said they would consider a salaried position and 36% said they would not.

GPs being pushed out of partnership?

As a Pulse analysis outlined in 2016, NHS England’s Five Year Forward View is quietly driving a move among practices to hand back their contracts, with GPs willing to work in salaried roles for foundation trusts, GP federations or under the ‘new models of care’.

As for the future of the small business model, NHS England announced plans to incentivise all GP practices to work in networks covering 30-50,000 patients.

Meanwhile, a Pulse survey last year found that just one in five GPs think the partnership model will exist in ten years time.

Furthermore, over half of partners have said they are willing to consider a salaried role if offered the right deal.

Readers' comments (28)

  • Peter Swinyard

    Inspired choice to lead this review. Let's hope that it reports swiftly and recommendations are implemented in full.

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  • Not without full consultation peter. Im a young GP partner and we are managing well at present by engaging with the wider cluster and working with other partners. Unilateral chanbe could be damaging

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  • More of the same amalgamating and federating then.Not really a rv of partnerships more of the smae BS.

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  • Nhsfatcat

    As long as the chair is not imposing his views first and foremost. We need to hear from the young GPs like James Weems as they are the future. Experience counts and we also need to help older GPs stay in the profession but we risk losing more ‘GP years’ by alienating the young.

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  • Took Early Retirement

    So, Nigel will end his career with a gong, (which some might say he deserves) but reading the above, I think it is just kicking the can down the road a little.
    I wonder if Ladbrookes will offer me odds on nothing much changing?

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  • A white British man nearing retirement. What better representative for a nostalgic resurrection of the dead horse of partnership? Visit a GP training scheme in a big city outside London and see how many white British males are in those groups. No-one in their right mind can afford to take on the financial and personal health risk of partnership. Those who remain will fight on in the trenches until they drop.

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  • It's not the partnership model that is the problem it is the outdated capitation model of funding that needs to change to a model that better reflects activity. Then and only then will Primary Care be sustainable.

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  • how about a new idea - pay each partner for the responsibility of being a partner. You could call it a Basic practice allowance!!

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  • David Banner

    Money talks and BS walks. Both partners and salaried GPs face intolerable pressure that has documented to death in Pulse, but if you want younger GPs to invest in partnerships then you have to ensure it is more profitable than salaried. With profits plummeting and responsibility rocketing, nobody in their right mind would take on a partnership.
    We need a guarantee that leases will be paid off, CQC will be abolished, and a boost in income. Assuming this is NOT going to happen, then please, please, please put us out of our misery and buy us all out, because the chaotic collapse of partnerships is destroying lives of both partners and patients.

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  • There is nothing actually wrong with the partnership model in's just that it has been willfully starved of resources for the past 15 years by the DoH to extent that younger GPs now (quite understandably) don't want to become partners any more....but now we need a review into why that is and what can be done to reverse the siutation...err I just told you in one sentence!

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