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Tight polyclinic contracts mean struggle for new providers, experts warn

By Steve Nowottny

PCTs may be forced to retender some of the new wave of GP-led health centres and practices in underdoctored areas because private companies and GP-led consortiums will struggle to meet demanding APMS contracts, academics have warned

An analysis from primary care researchers at the University of Birmingham says both GP and private providers have had to think again about their involvement because of the levels of risk involved.

It claims the Government's drive to stimulate competition with the forced introduction of the centres is likely to back-fire, with concerns about stringent key performance indicators and over financial viability, particularly in areas not under-doctored.

And study leader Professor Chris Ham, professor of health policy and management at the University of Birmingham, said: ‘It may well be we'll get a secondary market around equitable access, if the original successful bidders find it hard to make the contracts work either financially or in terms of the standards and indicators contained within them.

‘Commissioners in extreme cases might say, you're failing to deliver we're going to pull the contract.'

The analysis, published online by the BMJ, warned: ‘Some PCTs are expecting successful bidders to assume a greater degree of financial risk over time, based on their ability to attract patients. Providers are reassessing their willingness to take on this risk.'

Dr Rory McCrea, chair of Chilvers McCrea and a GP in Waltham Abbey in Essex, said: ‘When GP-led health centres were conceived it was in a different economic time – everyone's pencils are going to have to be sharpened to deliver the figures.'

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