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Urgent care company collapse leaves GPs just 10 days to find out-of-hours cover

A number of GP practices are being forced to urgently seek replacement out-of-hours cover after the private company providing services on their behalf gave them just 10 days' notice of ceasing operations.

Primecare, which forms part of the financially struggling Allied Healthcare group, wrote last week to over 20 Birmingham GP practices for which it directly provides out-of-hours cover, informing them they would stop services by the end of the month.

The decison also affects a number of CCGs, which have been told the services they contract from Primecare will cease by mid-December.

NHS Walsall CCG, NHS Sandwell and West Birmingham CCG, NHS Herefordshire CCG and NHS Nene CCG all hold out-of-hours and urgent care services contract with the company, while Primecare also forms part of a wider NHS 111 and out-of-hours contract covering more than a dozen West Midlands CCGs.

It comes after the CQC issued a letter to councils regarding Allied Healthcare on 6 November, warning of a risk of 'service disruption' because the provider could fail.

Primecare's letter to GP practices, sent 20 November, said: 'It is with regret that I write to inform you that as a result of the decision by our group, Allied Healthcare, to cease all operations by mid-December 2018, Primecare (a division of Allied Healthcare) will no longer be in a position to provide individual GP practices with primary medical services including GP out-of-hours opted-in cover, half-day cover, ad hoc cover or any telephone-based services as from 1 December 2018.

‘You are advised to make urgent contact with your relevant CCGs to discuss contingency plans for the provision of these services.’

Birmingham LMC executive secretary Dr Robert Morley told Pulse that 'around 24' Birmingham GP practices have 'subcontracted their out-of-hours care directly from Primecare'.

He said: 'These practices and their patients – of which there will be many tens of thousands directly affected by this – have been given only ten days’ notice to put alternative arrangements in place... 

'One can only hope that these practices will be able to find alternative services, but the problem is, will another provider of out-of-hours services be able to mobilise quickly enough and take on this extra workload at such a busy time of the year?

‘If practices cannot find an alternative provider in time, they will have to personally provide the care themselves, which is a huge undertaking.’

He added that the patients of the CCGs contracting Primecare to provide out-of-hours services would also be 'massively affected'.

‘The action of Primecare in just ceasing its activities without giving any safe or adequate notice to practices is absolutely disgraceful. It’s clearly paying scant regard for the care and patients it’s been responsible for.

'This is yet another example of the difficulties caused by commercial providers of services within the NHS – whether its back-room services or direct patient care,' Dr Morley said.

A Primecare spokesperson said: ‘We have been liaising closely with our customers to ensure that they are supported in securing alternative providers to deliver these services.

‘We are committed to working with both CCGs and GP practices to ensure safe continuity of patient care throughout the handover process.’

CCGs who contracted Primecare directed Pulse to the Department of Health and Social Care for comment.

A DHSC spokesperson said: ‘All CCGs and NHS Trusts have robust contingency plans in place to make sure individuals’ care and support needs continue to be met.

‘Our priority is to ensure essential services remain in place. We are working closely with NHS England to support the relevant CCGs to ensure there is no disruption to services.’

Readers' comments (17)

  • Azeem Majeed

    Once again, when a private sector company pulls out of providing an essential medical service at short notice, it is the NHS which has to step in to keep services running.

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  • I hope this doesnot fall on to those GP partners of those 24 practices to provide OOH cover.
    Block contracts will never be profitable. There should be payment per activity whether OOH or care during core hours. When service is properly funded it will sustain or this scenario will keep on happening again.

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  • Surely the contract doesn't let them pull out at such short notice? Most contracts have a 3-6 month notice period.

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  • Took Early Retirement

    Interesting. Why would ANYONE still be doing there own OOH by choice, unless in a remote location?

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  • Don't understand.

    It is the responsibility of CCGs to commission this service. Why would it fall to individual GP practices?

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  • Vinci Ho

    A DHSC spokesperson said: ‘All CCGs and NHS Trusts have robust contingency plans in place to make sure individuals’ care and support needs continue to be met.

    ‘Our priority is to ensure essential services remain in place. We are working closely with NHS England to support the relevant CCGs to ensure there is no disruption to services.’

    * This is the only time one has to read carefully what DHSC’s well recorded , politically and legally correct statements. The GMS contract clearly separates our responsibility of out of hour care from the government. Hence , it is the sole responsibility of DHSC via NHS England through CCGs to provide alternatives in case like this .

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  • David Banner

    Re Jam GP

    As far as I know, only this part of Birminghan and St Helens remained “opted in” after the 2004 contract (bar the odd remote country practice), because they had a strong effective co-op in place. 14 years later he he recruitment crisis has hollowed out OOH, so the opted in practices face doing the work themselves or (more realistically) opting out.

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  • I work for Primecare as part of my portfolio after leaving my partnership. A group of us made a tentative bid for OOH in 2016 but withdrew once we identified the moronic underpricing and the "disqualification if the tender bid exceeded a maximum figure".... It didn't fit the outside world's definition of a tendering process! We estimated running out of menu 2 years in.
    It takes 2 parties for a contract like this to fail: inappropriate price-fixing (the NHS's epic fail) and a Zombie company's inappropriate optimism. All they need to do is to meet up on a blind date and this is the neglected baby that follows. https://www.economist.com/britain/2018/06/28/britains-outsourcing-model-copied-around-the-world-is-in-trouble
    Oh and by the way, the 2004 contract does not pass this responsibility back the the GP when it fails but it was worth trying to bluff it to hide the CCG's failure here! Ha!

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  • Running out of money not "menu"... sorry

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  • @DT, Post-truth is right. When a contract is unaffordable to deliver, the only logical course is to terminate it. This is also what we are seeing with practices closing when they cannot pay enough to recruit and retain staff and make a living for the partners. In more flexible commercial situations it may be possible to deliver the same results for less cost. But in the bureaucracy of the NHS there is little room for manoeuvre - rightly because quality and safety are essential. Many GPs are subsidising the NHS - to the detriment of their on health and well being. The market is flawed because the NHS is almost the only buyer.

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