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Tory doctors want contract incentives to employ partners

By Gareth Iacobucci

Exclusive: The Conservative Medical Society has called for an overhaul of the GP contract to address the chronic shortage of GP partnerships, as a key step to promoting greater unity in the profession.

The society said that the contract should be ‘rebalanced' by setting aside a portion of core income to create a ‘partnership incentive figure'.

Incentives could be closely tied to the key Tory policy of handing much greater commissioning responsibility to GPs, which would require a flourishing independent-contractor model, Dr Paul Charlson, chair of the society, said.

The society was joined by the NHS Alliance in throwing its weight behind Pulse's One Voice campaign to promote unity in the profession and help support the creation of partnerships.

The NHS Alliance, which represents primary care organisations as well as GPs, said PCOs should favour practices that retained a high ratio of partners, and called for QOF points for continuity of care to support a stable independent-contractor model.

Dr Charlson, a GP in Brough, near Hull, called for a ‘significant amount' of money to be top-sliced from the global sum to incentivise partnerships.

‘One way you could do it is by reducing money in the global sum, top-slicing a significant amount that would then make it profitable for practices to take on partners.'

He said the Tories were acutely aware of the need to address the shortage of partnerships, and were keen to retain the existing model of general practice.

‘I think what the Conservatives would look at is a way of encouraging GPs to take partners who may take responsibility for things like commissioning of out-of-hours work or other services, and for partners to look at non-clinical work as being remunerative,' he said.

Conservative central office said it would be formally considering the society's proposals. The party would not commit to backing incentives for partnerships, but has said it will rewrite the GP contract, while shadow health spokesman Andrew Lansley has previously warned against Government moves to ‘undermine the independent-contractor status of GPs'.

Meanwhile, Dr Michael Dixon, chair of the NHS Alliance, called for PCTs to intervene to encourage practices to focus on creating partnerships and delivering continuity of care. He said: ‘If PCTs see some practices where there is a disproportionate amount going into partners' pockets and they have a disproportionate amount of salaried doctors, there needs to be a mechanism whereby PCTs and local clinicians can say, "that's not fair".'

He also said continuity of care should carry incentives through QOF points or LESs, to reward practices where patients saw the same doctor.

But the Department of Health appeared to rule out incentivising partnerships via the GMS contract, and said it had no plans to issue guidance to PCOs about local incentives.

A DH spokesman said: ‘Our broad policy is that primary care contracts should reward practices on the basis of the number of patients they serve, the relative health needs of those patients and the range and quality of the services provided.'

Dr Paul Charlson Sign the One Voice campaign petition

Pulse is running an email petition to call for all the main political parties to support moves to open up opportunities for partnerships.

The petition, which will also be submitted to all primary care organisations, will be a key element of Pulse's One Voice campaign to help bring the profession together.

It reads: ‘We the undersigned believe the declining opportunity for new GPs to become partners is at the root of the divisions within general practice, and is weakening the ability of GPs to act as strong advocates for patients and maintain continuity of care. We call on politicians to recognise the value of the independent-contractor model for providing innovation and long-term care for patients, and to explore contractual changes or local incentives to make it more financially attractive for practices to take on partners.'

To sign our petition, email your name and practice location to

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