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A faulty production line

GP practices set up not-for-profit company with trusts in bid to attract staff

GP practices in North Cumbria will start delivering their services via a not-for-profit company - set up with hospital trusts and a university - in a bid to reduce risk for newly-recruited GPs.

Under the plans, GPs will become salaried to the new company, although 14 participating practices - which together cover over 120,000 patients - will retain their respective GMS contracts.

The North Cumbria Primary Care Collaborative will be formed by the GP practices, Cumbria Partnership NHS Foundation Trust, North Cumbria Hospitals NHS Trust, Cumbria Health on Call and University of Central Lancashire.

The alliance will see practice partners retain their respective GMS contracts but sub-contract their delivery of services to the social enterprise, which will then employ all the staff, manage the business elements of the practices, and take on the premises lease or ownership.

GPs said they hoped the move would help attract new GPs, solve premises concerns and focus on clinical work.

 Lancashire & Cumbria Consortium of LMCs chief executive Peter Higgins said the decision comes as practices are struggling with workload, recruitment and premises concerns.

He explained that partners are increasingly worried about being the ‘last man standing’, as others leave and the new doctors coming in don’t want to take on a capital asset.

But Mr Higgins hopes that this ‘ambitious attempt to rebuild general practice’ will be a success and attract newly-qualified GPs to the area.

He said: ‘We can offer them portfolio careers, we can offer them experience in primary care, in community services and maybe in acute care, and that’s more attractive to a lot of newly-qualified GPs entering the market.'

The Cumbria Partnership Foundation Trust said that the solution should allow GPs to 'focus on clinical work'.

A spokesperson said: 'North Cumbria Health and Care System has recognised that in order to sustain services, it must support GP practices who are experiencing a shortage of GPs and increasing demand. 

'Therefore partners in the system have mobilised to support GP practices by establishing a not for profit company that can manage the business elements of running a GP practice such as HR, IT and estates so that GPs can focus on clinical work.'

It added that '14 practices in Cumbria, with 120,744 patients' had 'registered their interest in becoming part of the alliance'.

The first three GP practices are due to join the new alliance from June.

'The business case is now in its final phase and undertaking due diligence on the first three practices in the first wave with an indicative timescale of June 2018,' the trust spokesperson said.

As Pulse has reported, GP partners are increasingly concluding that life may be better as a salaried employee, to escape from the pressures of partnership.

Nearly two years ago, half of partners surveyed by Pulse said they would be willing to go salaried if 'offered the right deal'.


Readers' comments (4)

  • Bornjovial

    Advantage- GP`s and staff can be paid as independent contractors which NHS Organizations and surgeries are prevented from doing(IR35).
    Freedom to organize as they see fit

    Private providers have to pay VAT (charities are exempted I think, as are NHS trusts.
    Form should follow the function and the function is presumably to be ready for ACO contract!
    Don't we live in interesting times

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  • Not-for-profit concept assumes that income, as in earned, is not a profit. There are all sorts of mechanisms wherby those inside can indeed profit in such organisation by way of salaries and fees. There can be subcontracts with a profit making management company, or with teams which could inculding run for profit GP practices.

    Yes, many complain of vested interest, a tactic to block all innovation in the health service. Vested interest means that you are extra interested, it is entirely beneficial concept; the only caveat being it must be open and everyone know who owns what, and who has an interest.

    Unless formed as a Community Interest Company, a not-for-profit organisation can be unwound for profit to members later, as did building societies when becoming banks.

    I worked with a trendy CIC (SecureHealth Ltd) which had heart in the right place, ambitions in the prison service. Failure to consider margins, indeed to have the discipline of that wicked profit, meant it went bankrupt with £1.4M debt and PCT had to take over running Wandworth priosn healthcare over immediately and take over the debt. SecureCare had been awarded the contract because of its saintly not for profit status; it had not won the competitive tender. Before it was given grants to tender probably outside EU rules. Finding out what really happenned is too easily blocked

    Apart from running a village hall, a not for profit company organisation can be a shield. They are dishonest and creepy things. Virtue signalling. Avoid them.

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  • There is no system of company organisation that of itself will ensure that it is virtuous. Some might be more easily manipulated than others, but I am sure accountants with the right mind set can work with any structure.

    Setting up as a Charity would probably have been far more difficult (and perhaps impossible) given that it would then have much stricter rules and oversight. But even they can and do have issues.

    I laud that they are at least trying something rather than just wringing their hands and moaning that it is so unfair that others won't just give them more money or provide a solution.

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  • The reorganisation may temporarily address financial problems but it does not change the status quo of the CQC or GMC. Anyone of them working can be a Dr Bawa Garba hung out to dry.

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