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ICB questioned by local GPs who feel they may be ‘forced’ into salaried service

ICB questioned by local GPs who feel they may be ‘forced’ into salaried service

Exclusive Two LMCs have submitted a vote of no confidence to Staffordshire and Stoke-on-Trent ICB following concerns GPs could be ‘forced into a salaried contract’.

In a letter dated 4 September, both North Staffordshire LMC and South Staffordshire LMC stated the ICB has made ‘no real engagement’ with primary care and called for the removal of the primary care leadership if changes are not made within three months.

The LMCs stated that on ‘multiple occasions’ the ‘future of the partnership model has been questioned’ coupled with ‘threats that [GP partners] will be forced into a salaried contract’.

Both LMCs also claimed that the ICB’s drive to move enhanced services and budgets out of independent practices and contracting them to larger organisations will lead to many practices failing or handing back contracts.

South Staffordshire LMC also cited the ICB’s decision to scrap its visiting service ‘without any consultation or engagement at the beginning of the winter months’ as evidence of the Board’s lack of understanding of how the practices work.

The letter stated: ‘Both North and South LMC committees have passed no confidence votes on the management/leadership overseeing the primary care team. We had another emergency meeting with the elected representatives of our GP colleagues and have expressed their concerns about the primary care team’s views and the direction of travel.’

The current direction of ICB behaviour is seen as ‘a threat to the sustainability of the Independent Contractor GP Partnership model’ and would risk undermining continuity of care and quality of services, it said.

The ICB’s chair and chief medical officer have met with the LMC chief executives to discuss the letter.

The two committees set out their need for ‘clear commitment of support’ of the independent contractor model and improved communication and engagement with GPs.

They also called for an independent review of their concerns by someone from outside the ICB – jointly agreed by both parties – to deliver an action plan within four weeks.

The letter said that if no outcomes have been acted on within three months the LMCs will proceed with ‘disengagement with the ICB and press for national removal of the ICB leadership in charge of [the] primary care team’.

Chief medical officer for the ICB, Dr Paul Edmondson-Jones, said: ‘Since the ICB received the letter from the LMCs, the ICB chair and I have met with chief officers from both committees to discuss their concerns. 

‘We have agreed we need to work together on a solution which allows for more meaningful engagement and better ways of working collaboratively. This will ensure people across Staffordshire and Stoke-on-Trent continue to get the care they need.’

The ICB is currently in the process of recruiting a new chief executive.

Labour leader Sir Keir Starmer has said the GP partnership model is ‘coming to an end of its life’ and that the NHS needs ‘more salaried GPs’.

In June, GP leaders at the BMA wrote to the Labour Party in a bid to change its position.



Please note, only GPs are permitted to add comments to articles

Not on your Nelly 26 September, 2023 4:16 pm

It is the future and we can fight all we want. The money is with the ICB and they have already starved practices of funding by introducing PCNs. They will continue to make practices unviable. They just don’t know what is about to hit them when GPs work like hospital consultants, doing less work for more pay and less stress. Sick leave. Check. Employment rights. Check.

Nick Mann 26 September, 2023 8:16 pm

If it would genuinely provide improvement in patient care, I think many of us would swallow this and comply. But it won’t, patients will get, or not get, poorer quality care. It’ll be DES on steroids. Loss of continuity and deprofessionalisation are serious long-run mistakes. Done for all the wrong reasons. Good on Staffordshire LMC.

paul cundy 26 September, 2023 9:14 pm

Dear All,
“We have agreed we need to work together on a solution which allows for more meaningful engagement and better ways of working collaboratively. ”
Yep, that sort of nonsensespeak really inspires confidence that these guys really know how to deliver healthcare.
Paul C

David Church 26 September, 2023 10:36 pm

It is only a few short years since a similar body not too far apart, but not in Staffordshire, was so highly allergic to the idea of having a salaried GP on their staff, that they were willing to put pressure on available GPs to enter an illegal contract arrangement with them, just to avoid any possibility of having a salaried GP working directly for the NHS body!

Born Jovial 27 September, 2023 5:55 am

I agree with the LMC comments as jobbing GP in Staffs. The main issue is decisions are made by the ICB to award significant contracts without tendering to an large organization in Staffs whose employees form the bulk of the ICB board. It seems a conflict of interest for an organization to have its own employees in a commissioning organization which awards contracts.

Can the Pulse editor look into the constitution of the board of the ICB and see for themselves what the issue is.

Syed Mehdi 27 September, 2023 6:58 am

THE BACK BENCHER SAYS, THEY NEED SLAVES NOT INDEPENDENT PROFESSIONALS! They themselves are guzzlers and swiggers, hence the country is in the state that it is.
For one thing hordes of MANAGERS in all capacities needs to be reduced, make the merit doctors more in command, this profession should not be controlled by BACK BENCHERS.

Centreground Centreground 27 September, 2023 7:46 am

In some cases and increasingly, LMCs and ICB board positions are occupied by those who are simply there in these roles to gather early information about upcoming contracts and scheme changes to serve their own or their joint business /partnership purposes and not to serve the wider good of general practice. They dilute the numbers of dedicated GPs also in these roles who clearly serve the professional common good. It is important the wider body of GPs continues to recognise this.

Carrick Richards 2 October, 2023 3:12 pm

Not sure if any ICB see engagement with GPs are a main focus of their job description. We’ve heard little from them. They are being asked top control secondary care contracts and tariffs. That’s were the money is; that’s where the change they were set up to achieve might come from.

Then again, what do you think would happens if NHS/ DHSC squeeze GPs enough to get them to vote for a work-to-rule?