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Whole town looking at employed model of general practice

Exclusive A town in the south of England could see its entire general practice population give up their independent contractor status and move to an employed model, Pulse has learnt.

GPs in Gosport, south Hampshire have approached the ‘new model of care’ provider in the region to give a presentation on how a salaried model could work for them, the GP lead has told Pulse.

Such a move could see a ‘significant reduction’ in the number of traditional practices in the area, he added.

GP leaders have warned that the new models of care could lead to practices being ‘devoured’ by hospitals.

The new models of care promoted by NHS England provide both primary and secondary care services.

The Better Local Care (South Hampshire) Multispecialty Community Provider (MCP) vanguard is being led by the local foundation trust.

Pulse has already reported two Gosport GP practices sought takeovers by Southern Health NHS Foundation Trust, after the workforce crisis left partners facing ‘physical and emotional collapse’.

But the GP lead of the South Hampshire MCP vanguardhas told Pulse the other nine practices in Gosport have asked for a presentation on how the new model could work for them.

Dr Donal Collins told Pulse that the model they were considering would deviate from traditional salaried model by setting a minimum earnings threshold and keep GPs invested in the practice, instead of punching in and out.

However, he also noted the move could see a significant reduction in the number of traditional GP practices in the area.

He said: ‘All the practices in Gosport have indicated they want us to present a detailed plan of the employed model for the whole area, what it would mean for them, and what it would mean for patients.’

This would be partly done through the MCP, which includes 30 GP practices, Southern Health and community providers.

And Dr Collins added the new model was already making a dent on workforce issues, with two newly qualified GPs from neighbouring Portsmouth approaching one of the Gosport practices asking to work In the vanguard.

He said: ‘Because it’s a bigger wider system, the younger guys coming in are finding it attractive… So for them it was part of being an employed salaried model, but not having the risks of taking on property ownership or leases. Property is a bit of a toxic thing.’

Dr Nigel Watson, chief executive of Wessex LMCs has confirmed that Gosport general practice is under immense pressure, but said ’about half the practices are exploring this option’.

What are the new models of care?

Simon Stevens - online

Simon Stevens - online

Nine hospitals and 14 GP-led bids were been given part of the £200m funding to provide integrated primary, secondary and social care, which will allow them to appoint GPs, as part of the the implementation of NHS chief executive Simon Stevens’ Five-Year Forward View.

The new models will employ a mix of primary and secondary care staff to deal with commonly encountered conditions such as diabetes, dementia and mental illness.

Some will see some employing ‘social prescribing teams’ who will be able to refer patients to voluntary organisations and local authority services.

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Readers' comments (30)

  • Can we actually offer "cradle to grave responsibility" in any meaningful sense anymore?
    How many GPs now do 10 session weeks?
    How many do their own OOH?
    How many do not take holidays?
    Also correct that there is "no business model that works for socialist ideology", so the inference should be that we ditch the fixation with ideology and learn from models in place elsewhere in Europe.

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  • Socialism has an expiry date and ours has just arrived.

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  • Joe Mcgilligan is spot on. What do patients want and do GPs really want to give up resposibility for, and the many different rewards of, cradle to grave care of their patients. As a patient, I am appalled and, as a recently retired GP, I am very sad. It is long past time for a proper discussion about the merits and needs of general practice with patients, the public and managers. Perhaps it could still happen if there is sufficient will...?

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  • @ 11:13

    'Our practice is run extremely well, by us.
    Not every partnership is collapsing.'

    Says....you! And you are very objective cause you have NO conflicts of interest right?

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  • The evidence is strongly against non partner run practices being cheaper or better quality when they compete on an equal playing field ie same £/head.
    'Professional' corporates are handing back their contracts as quick as partners now the £200/patient rates have fallen. PCT/manager run practices often had recruitment, quality and retention problems.
    Pulse reported in recent weeks that Welsh health board run practices receive £29/head more to pay for staff.
    So no, leaving management solely to 'managers' is not the answer.

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  • The basic concept is flawed because funding is so different. Trusts get better funding per patient. GP land may be OK for some, but its principle is flawed in so much as funding per patient and not activity has seen consultations double with a cut in profit of 50%.
    The principle of General Practice s no longer valid or fair or equitable and it must and will fail because the % investment has fallen from 11% to 7.5% and the % consults have risen from 60 to 90%, all because it is paid per head.
    So the DOH will dump and dump and dump.
    Wouldn't you if you were a manager and found mugs to do more and more work for less and
    less.
    Of course, some GPs are OK = their finding per head may be 220. The one going down only get 100.

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  • Vinci Ho

    Interesting argument about the difference between PACS and MCP in terms of being able to charge patient for private consultation. Everything is only down to political 'interpretations' anyway.
    In fact , this may be the catch whether things can work or not . And as I always say , weekend routine GP appointments should be charged with a fee.

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  • I think GPs should look at leaving ICS but not relinquish their Independence to FTs .

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  • @ Dr Gerada,

    Freelance snipers, yeah! ( I kida mean it )

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  • You simply can't let patients get in the way of the smooth running of the health service! The system must balance and patients just add cost and uncertainty! Everyone must watch 'The Compassionate Society' episode of Yes Minister to understand what I am getting at!!

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