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Sainsbury's to open up to 200 GP franchises
04 Mar 09
Exclusive: Supermarket giant Sainsbury’s plans to roll out up to 200 in-store GP franchises in a move that will dramatically ramp up the role of the private sector in primary care.
The company has already begun approaching GPs to run surgeries alongside dentists and other health services in what it calls in-store polyclinics, claiming patients want more of the NHS under one roof.
Stores in London and Leeds are among those earmarked for the first wave of Sainsbury’s-branded GP services, in a move causing some GP leaders to voice ‘huge ethical concerns’.
Dr Mohammed Jiva, secretary of Heywood, Middleton and Rochdale LMC and the GP who opened a pioneering Sainsbury’s surgery in Manchester a year ago, has been given a pivotal role in the plan. His company PriMed Services will be charged with vetting applicants from across the country to award franchises to GPs.
Under the terms, GPs could run extended hours or in-hours services – or even locate entire branch surgeries – at more than a quarter of the 785 Sainsbury’s stores.
NHS services would be funded by PCTs and available for patients on the lists of participating practices, and GPs would also be able to carry out private work at the stores to boost their income.
Since last March, Dr Jiva has employed three other local practices alongside his own to offer PCT-funded extended hours surgeries at Heaton Park Sainsbury’s, which has also launched podiatry and dental services and has plans for chiropody and physiotherapy.
He said: ‘We’ve done more than 1,500 consultations and haven’t had one complaint.’
Dr Jiva added: ‘We’ve been talking already in London and Leeds about the first franchises. Patients will be able to get a full health MOT at Sainsbury’s, while the stores get the footfall and increased sales.’
He said a major incentive for him was that he could be paid for his extended hours work without any superannuation deductions as the income comes via his private company.
Dr Jiva said GPs would be offered three-year contracts, paying his firm £100 per month and rent to Sainsbury’s of around £10 an hour.
Franchise-holding GPs would then negotiate NHS funding with their PCT.
A Sainsbury’s spokesperson said: ‘We’re very confident these services will be popular with customers who appreciate the convenience of having services under one roof. We’ve done a lot of preparation.’
The scheme comes as Sainsbury’s also won a contract to host a GP-led health centre in Chelmsford, which is being developed in partnership with Mid Essex PCT.
But the prospect of hundreds of GPs donning Sainsbury’s name badges has split GP leaders.
GPC negotiator Dr Beth McCarron-Nash said: ‘I have concerns if the relationship of trust is unduly influenced by commercialism. Patients may be bombarded with information they would not usually receive in the health arena. I have huge concerns about the ethical dilemma faced by doctors.’
But Dr Richard Vautrey, deputy GPC chair and a GP in Leeds, said: ‘If it’s basically a branch surgery it should be treated like any other branch surgery.’
Dr Budgie Savage, a GP in Lambeth, south London, said her practice had been approached by Sainsbury’s but had declined the offer because of objections to the role of the private sector in the NHS.
Readers' comments
My main concern is that it might take GPs away from their normal surgeries. Getting an appointment is hassle enough, without the prospect of the doctor you want to see being away at Sainsbury's
It also poses the question of how effective a GP can be when treating total strangers. Surely it's not envisaged that their usual patients will trek out of town to Sainsbury's stores? And the potential for chaos is, I think, huge - I can just see the Daily Mail headlines when a manipulative, suicidal patient blags a scrip for lethal analgesics...
It is a way of the GPs doing something that the consultants in hospitals have been doing for a number of years. What's the harm? As long as their practice commitment is continue to be fulfilled it could be a win win.
Looking at Dr Jiva's figures on his Sainsbury's practice, it is hard to see where the profit comes from. His company plans taking 100 a month fee for doing nothing,and then there is the 10 an hour to Sainsbury's. His figures were 1500 patients seen in a year - about 30 a week.
How many hours a week was he using at Sainsbury's to get these 30 patients a week? I assume Sainsbury's wanted a doctor there seven days a week for at least a couple of hours a day, so 140 to Sainbury's a week. That would mean paying 4.60 a patient seen to Sainsbury's and just under 1 per patient to him - 5.50 that we pay to see each patient. Add reception costs and connecting to surgeries or writing to patients' GPs. Think then what payment we would need to get from each patient to make a profit, and where would we we get that payment.
We would need to be getting round about 35 per patient to even pay us 60 an hour, and I can't see many patients and fewer PCTs paying that. If ever I heard of a definition of a waste of time and money, this scheme certainly qualifies from everyone's point of view, except Dr Jiva who might just persuade enough gullible GPs to part with 100 a month to him.
While there is anything left of the NHS, why get into bed with a multinational? We have objected very strongly to a Darzi surgery setting up in the same village as us. Joining the private sector is the end of traditional general practice and will be cost inefficient.