Exclusive The Royal Wolverhampton Trust is exploring alternative solutions to fill GP vacancies in the eight fully salaried practices under its control amid ‘high’ cost pressures from existing vacant posts.
The Wolverhampton model, which sees the trust employing salaried GPs to work across GP practices, was highlighted earlier this year after reports that former health secretary Sajid Javid was looking to roll it out across England.
But Board papers published by the trust on 2 August said that it is struggling to recruit, with 4.8 whole-time equivalent GP posts currently vacant.
The minutes from a meeting of the trust’s performance and finance committee dated 22 June said deputy chief people officer Adam Race ‘confirmed that the vacancy factor relates to 4.8 GPs within the service and confirmed that costs were high’.
The report added that the vacancies were creating ‘a pressure on agency spend’ but that the trust ‘is not planning to fill some of the GP vacancies and is instead looking at alternative solutions’.
A spokesperson for Royal Wolverhampton Trust said: ‘In line with the current national shortage of GPs, we are always exploring alternative options.’
The latest NHS Digital figures on GP numbers, published on 28 July, show the profession has lost 1,806 fully qualified FTE GPs since September 2015.
Pulse reported earlier this year that the trust is also in the process of merging the eight GMS contracts under its control into a single contract.
An update on the merger in board papers published by the trust on 7 June said it had ‘received agreement from the CCG that all of the GMS/PCN monies can flow to the trust account to assist with flow of finances’.
The trust told Pulse that moving the funding from multiple separate accounts to the trust account was an ‘administrative task’ and had been undertaken subject to the agreement of the individual practice contract holders and in agreement with the Integrated Care Board (ICB).
A report from a committee meeting on 23 March said that the trust has been working with the existing contract holders ‘over the last six months to gain their support to merge to a single GMS’.
It added that ‘a lot of engagement has taken place with the partners and that six of the practices have a consistent view with simple questions and that two of the practices are more complex’. It also said that there were ‘potential conflicts of interest where some of the partners are landlords on the estate’.
According to the report, the trust has also received ‘verbal feedback’ from NHS England on the change of property arrangements so that ‘partnerships will not need to hold a lease, which will eliminate any liability issues’.
‘The Trust will hold a lease between the Trust and each of the respective landlords, with the exception of one which has further complexities around the partnership model,’ it added.
A spokesperson for trust added: ‘As part of our vertical integration model, we have always worked to identify opportunities to support primary care to be as efficient as possible, releasing clinical staff to focus on patient care. This potential merger of practices continues this good work and creates more opportunities to improve, such as aligning our EMIS system.’
The Wolverhampton model started in 2016 with three practices and housed nine until recently, when one left due to the challenges of it sitting in a different CCG area.
It was highlighted in an article in The Times in January – based on a letter from Sajid Javid to the Prime Minister seen by the newspaper – which said that the then health secretary was considering introducing academy style ‘reform trusts’ that would bring together primary and secondary care. It added that the idea had been ‘dubbed the Wolverhampton model’.
Pulse later revealed that Government officials had visited the trust in November last year to ‘explore alternative ways to deliver primary care’.
In March, a report by think tank Policy Exchange recommended that the GMS contract be phased out by 2030 and most GPs be contracted by scaled providers such as hospital trusts. In a foreword to the report, Mr Javid said that it ‘offers some credible ideas and insights’.