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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.

Read more here

 

 

Readers' comments (30)

  • Took Early Retirement

    Gosport- gateway to Fareham. Luton-on-sea.

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  • It would be interesting to know what conditions have been offered to Practices both salary/perks and for premises owners.
    The devil is in the detail but we need to keep options open i.e. if we have any !

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  • www.veoh.com/watch/v21038684cmxmQW3Q for those who want a laugh and cry!

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  • Way to go

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  • I have it on very good local authority that not all partnerships are on the brink and are not best pleased with this announcement on their behalf with little consultation . Conspiracists saying this is a Southern Health takeover of primary care .

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  • A bottom up opinion...well almost...

    YES, there are some extremely well run and conscientious independent GPs / managers running their practices BUT in my observation and experience working "under" them since 1999 they OFTEN, frequently (but not all)...

    *Work in a kind of "closed shop" environment, often self-back patting on what they think they do well.

    *Work in the delusion that they are somehow "a business" when their funds come as a lump from Government and their "customers" are as tied in as they are to energy companies. Free to leave but often don't.

    *Many GPs are business (money) focussed rather than patient and staff care at heart. Too often I see a poor GP with two homes, holidays twice a year abroad, a huge non-environmentally friendly car (based on status), whilst they "cannot afford" to buy equipment that works, is maintained, give proper pay scales for grade of work, even lunch breaks for full time staff!

    * GP's often perceive they are super intelligent because they got into Med School, yet often miss simple things. GP intelligence can be great in tunnel vision understanding the depth of a subject down to atomic level, yet so often miss the bigger picture and lateral thinking.

    I could go on with various examples and I am not sure a central management to GP land would be better either. It depends on so much.

    YES, GPs do deserve more pay than the rest of us. I don't deny the responsibility and the commitment, but right now and since the mistake of 2004 QOF, it is ballooned out of reason and the differentials are unacceptable.

    We need a management that understands ALL roles and what they can offer safely. Use peoples skills and allow some transition with experience and further training.

    For years we have seen, up to appraisal and revalidation, GP's who did as little as possible to learn beyond their qualification. whilst some nurses (not all) have worked their butts off for 20-30 years doing modules in this and that.

    I thought I was stupid getting zero GCEs, but I still came middle when I did an exam with mainly GPs at Warwick Medical School. That means 50% GP's scored less than me, yet working in Primary Care means many nurses careers are strangled by GP's who have little knowledge about the team who they employ and the potential to improve patient care and staff motivation.

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  • 3.12pm clearly very embittered suggest she/he either moves to find a practice that treats her/him better there is a huge shortage of practice nurses after all . Alternatively suggest she/he compares pay differential in uk to other developed economies sorry but doctors do deserve to be paid more than nurses for the responsibility they carry and that is the case across the world but if the docs she /he works with are not providing a good service then maybe she/he should whistleblow and not tar all GPs with the same brush

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  • Anonymous | GP Partner31 Mar 2016 5:35pm

    Sorry if I come over as bitter, but no, just frustrated.I didn't explain that my experience comes from working in 8 different practices but have been where I am for 12 years. You may see I have samples quite a bit of independent GP employment. However, this is not just my experience but that of many practice nurses. Probably as high as 50/50 so there are some great employers too, but not enough, and not enough sorting out the bad ones hence why salaried for all could be a good thing.

    I did acknowledge that GPs should have more pay than other members of the team and never disagreed with that, but not triple the pay.

    I have whistleblowed but it's all very subtle and accumulative and very isolating. Now I am near retirement I am happy to keep up the pace of learning and more modules and hoops, but sometimes the devil you know....

    Just wish some GPs would stop tarring all nurses with the same brush. Some of us are covering up lots of things you miss and saving butts.

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  • The BMA contract and salaried status is the way to go
    The extra costs are then some one else's worry and we can advocate for good medical care and longer clinical time with patients
    Would be a win for patients and doctors especially extremely stressed partners who shoulder financial risk and management stress
    May be we can all be locums and work by the hour?

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  • I cannot ever understand how a system that is so utterly discriminatory exists for so long.
    It is completely absurd that one GP gets 110 and another 220 pounds for the same work.
    There are some differentials in morbidity and rentals and so on, but the difference in funding is so great as to be abhorrent.
    To add insult to injury, the guys getting 220 are wondering what the 110s are complaining about, the whingers, I am allright Jack.
    How can it be right that health boards get 30% more per patient.?
    We should all resign, really.
    But this is fair Britain, apparently.

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