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At the heart of general practice since 1960

16,000 patient practice on short-term contract as six APMS providers pull out

A 16,000 patient practice has been left on a short-term interim contract after six of the seven APMS providers invited by NHS England to tender for the contract pulled out saying it was unviable.

The partners at The Mandeville Practice in Aylesbury, Buckingham handed back their contract last year after being unable to replace a recently retired senior partner, and finding locum costs unsustainable.

Since April, the practice has been run by local APMS provider Practice U Surgeries Ltd, on an 18-month contract.

Former partner Dr Gill Beck says it has been left with ‘no security for its future’, adding that commissioners were now getting to grips with how the practice can be run long-term without destabilising adjacent practices.

Local GP leaders said the practice that was no longer viable under the traditional funding model and which would become a ‘poisoned chalice’ if recruitment problems continued.

Speaking on the current state of general practice at the BMA’s Special Representative Meeting (SRM) this week, Dr Beck told delegates: ‘Within 18 months of my retirement from that practice, my partners handed in their contract.

‘Seven private companies came round to look at this, to see if they would take it over. Six withdrew saying it was financially unviable. My practice has gone to a one-year contract with a private organisation with no security for its future.’

Dr Beck told Pulse after the SRM that her remaining partners ‘left because of workload issues and with losing MPIG, it became unsustainable’.

She added that the CCG had recently taken on devolved responsibility for commissioning primary care from NHS England, and were now trying to ‘see what they can do’ without dispersing over 16,000 patients onto neighbouring surgeries.

But Louise Patten, chief officer of NHS Aylesbury Vale CCG said that the retirement of the contract ‘was a chance to commission a service that is more aligned with the Five Year Forward View.’

She added that the consultation with hospitals and GP providers: ‘Is in order to develop a long term solution that takes into account the needs of the local population and offers an innovative and robust solution for patients’.

The Five Year Forward View champions the use of new models of general practice, such as GP-led groups of community care organisations, dubbed ‘multispecialty community provider’, while managers have pledged incentives like ‘simplified’ QOF arrangements to tempt GPs from the national contract.

Pulse has already revealed how an MCP in adjoining Hampshire is putting together a proposal for salaried general practice which could see an entire town switch to an employed model after recruitment issues.

Berkshire, Buckinghamshire, and Oxfordshire LMCs chief executive Dr Paul Roblin speculated the CCG could be contemplating something similar for Thames Valley if the interim provider didn’t work out.

He told Pulse: ‘An MCP is obviously what they’re hinting at, I can’t think of an MCP locally that can take that on. So they’d have to manufacture on from scratch.’

He added: ‘I think they’re desperate to find a solution, there’s no obvious solution for commissioners if you have to run a list based practice and you haven’t got the workforce to do it. It’s almost a poison chalice because no one wants to take it on.’

Stop Practice Closures campaign win

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Copy of Stop Practice Closures-logo-online-330

Pulse has been lobbying for an emergency support fund to protect struggling practices through its Stop Practice Closures campaign.

After initially saying that practice closures were ‘not always a problem’ NHS England annouced last year it would set up a £10m support fund for struggling practices.

Area teams identified over 800 practices that met NHS England’s criteria.

The funding pledged was expanded to £56m for ‘practice resilience’ in the GP Forward View.

Readers' comments (11)

  • Traditional funding a poison chalice, you can say that again.You cant polish a turd.

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  • Yes you can

    Christmas 2015: Professional Considerations
    Death of a proverb
    BMJ 2015; 351 doi: http://dx.doi.org/10.1136/bmj.h6226 (Published 11 December 2015)
    Cite this as: BMJ 2015;351:h6226

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  • this is awful - don't GPs care about their patients ? - why did the partner retire. if only GPs worked for free 24/7 then this practice could be saved.

    thankfully our forward thinking masters will probably bring a law in that states that GPs will be banned from retiring, the RCGP will endorse it as good for patients, and the GPC will say it's better than nothing. far fetched? probably not.

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  • Lets talk Turkey - you're a doctor and your employer cuts your GP practice income by between £200,000 and £250,000 increases your workload but expects you to earn less - WHAT WOULD ANYONE ELSE DO? You'd stick your two fingers up and clear off in search of greener grass. Hence two years ago there were 38,000 GPs in the UK. 20% left for Australia or retired. Leaving around 30,000 GPs. Another 30% intend to leave by this time next year, which will leave 21,000 GPs - Government minister, Nicky Morgan, appearing on BBC Question Time two weeks after the 2015 General Election, said the government were working with 20% of GPs to roll out new working practices ( based on 30,000 GPs remaining) that's 6,000 GPs working to achieve 24/7 which I take to mean that another 14,000 GPs are considered expendable. 350 GP practices set to close this year - is this the run up to private health insurance - GOODBYE NHS as we know it?!

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  • UK citizens are so overwhelmed by Tory spin that they still vote for them unaware of the murky waters that await.
    Congratulations to all Tory supporters, cardigans in lmcs and nhse. You'll have your way over dead bodies and RCGP=Royal Cartel of GPs will make sure you have full coffers by the time the rich boys leave.

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  • Louise Patten, chief officer of NHS Aylesbury Vale CCG said that the retirement of the contract ‘was a chance to commission a service that is more aligned with the Five Year Forward View.’
    Precisely: they want trad GP to die whatever they say about "jewels in the crown."

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  • When I retired on 31.3.13 (because the HSCA 2012 came into force on 1.4.13), my practice got a demand from CQC to say why I had been *allowed* to retire without prior consent from the CQC!
    5th May 9.59 pm, you may be onto something here!
    I'm not sure how my old practice could have prevented me - or the two partners who have retired since - from retiring: but no doubt someone will think up something soon...
    PS for clarity, none of us retired early...

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  • shows the value and volume of work done by one partner. We will be missed.

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  • But Louise Patten, chief officer of NHS Aylesbury Vale CCG said that the retirement of the contract ‘was a chance to commission a service that is more aligned with the Five Year Forward View.’

    She added that the consultation with hospitals and GP providers: ‘Is in order to develop a long term solution that takes into account the needs of the local population and offers an innovative and robust solution for patients’.

    Translation:

    But Louise Patten, chief officer of NHS Aylesbury Vale CCG said that yet another practice collapsing was a clear indication that the Five Year Forward View had the right ideas about the end of General Practice.

    She added that botched last minute talks was needed to cobble together some unsustainable, unresourced, non-evidenced solution that would take into account the needs of the Treasury and offer a short-term fix for patients.

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  • John Glasspool

    Mary, I went early. I don't know if my practice got a snotty letter after I went or not, but all I can say is that, yesterday, as I walked 10 miles along the Kennet and Avon Canal towards Bath, in warm sunshine, I gave not a Shti for the CQC.

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