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GPs go forth

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)

  • Primary care hospitals vs Secondary care hospitals. Interesting.

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  • As long as the patients get good care it does not matter whether its is MCP or PACS.
    Unfortunately many Trusts have been declaring themselves to be in deficit but have set aside huge amounts for "restructuring plans" to buy off CCG`s in deficit and forming ACO.
    Obviously this is not a level field for GP`s to compete with.
    Please see HSJ article on same
    "Department of Health has sent accountancy firms into NHS organisations" - 20 Trusts and CCG`s to ensure their accounting is correct!
    The corollary is that DOH is asking Trusts to fudge their accounts so as to appear to be in better financial position than they are!
    "may you live in interesting times" -was never more appropriate for medical politics.
    Can the editor get the list of 20 CCG`s and Trusts which are being re audited by DOH?

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  • I would be most interested to see what salaries and t&c's are on offer. can't be good for the current partners who are used to being bosses and not dictated to by clip holding noctors.

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  • Bob Hodges

    Good luck to them, but the thought of having to do this myself makes my mind wander towards Australia, Canada, Ireland the Falkland Islands. Anywhere but here.

    'Salaried' and 'Gosport' in the same sentence is a unique overlapping of two distinct circles of hell.

    DOI: From Chichester.

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  • Vinci Ho

    A Chinese saying,' the situation and circumstances are lot stronger than man'
    No rights or wrongs
    Question remains , what are the terms and conditions of each employee?

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  • Vinci Ho

    But then again,
    The same saying applies to all including politicians and circumstances are everchanging with time and history ......,,,,

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  • To all deluded partners out there,

    Doctors should stick to what they do best and let the managers do the rest.

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  • @11am

    Our practice is run extremely well, by us.
    Not every partnership is collapsing.

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  • Has anyone deigned to ask what their patients want? The cradle to grave responsibility will be gone with patients losing their registered doctor and UK general practice as we know it will sink rapidly into the mess of ACO's in America. For those who follow Gavin Preston M.D. he has been warning of this folly for years! There needs to be an acceptance by those in charge of the NHS and those that pay for it that there is no business model that works for the socialist ideology that is the NHS. We need to accept how much it costs and find a way to pay for it.

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  • A couple of issues:
    - No one seems to be able to answer the question of whether an FT running a PACS can also charge patients privately in the way that it can for 49% of its normal capacity. If so, PACS is clearly better than MCP as it means you can earn more to pay for all the resources you need to exist.
    - Competition and Merger Authority will probably need consulting on this as it could result in a monopoly provision in an area. Expect this one to come up a lot more as we progress down the ACO/MCP route.

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