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BMA leaders reject proposal to put GP contract out to ballot of profession



Doctor’s leaders have voted against the immediate withdrawal and a subsequent ballot of the new five-year contract.

Delegates at the BMA’s annual representatives meeting in Belfast heard today that the GP contract should not have been agreed without prior vote held by GP BMA members. 

The motion, which was put forward by the BMA’s London Regional Council, also suggested that ‘the real agenda of GP contract change’ is to have practices ‘hastily’ sign up for primary care networks (PCNs) and push them towards ‘extinction’ in favour of an Integrated Care System (ICS)-run primary care.

But GP leaders argued that PCNs aim to ‘retain GPs’ independence’ and protect practices from the Integrated Care Provider (ICP) contracts.

The meeting voted against the motion, which called the Government and NHS England to remove the five-year GP contract and allow all GPs and trainee GP BMA members to vote on a new contract.

Under the GP contract, released in January by NHS England and the BMA, practices will be provided with extra funding to join PCNs, which will see groups of practices serve 30-50,000 patients.

All networks were required to submit registration information to their CCG by 15 May 2019 while CCGs had until 31 May to confirm registration requirements and approve variation to GMS, PMS and APMS contracts for all networks.

GPs have previously warned that tight deadlines have prompted practices to rush to submit their plans while some have faced difficulties in trying to work collaboratively with neighbouring practices.

Anna Athow from the London Regional Council, who put the motion forward, said: ‘Within three weeks of January’s NHS long-term plan, a new GP contract was published already agreed by GPC leaders. GPC’s aim is to push it through by next Monday, with 100% population coverage, but there has been no vote by GP BMA members. Yet this GP contract reform is pivotal so covering the whole of England, with ICSs and ICPs, the English equivalence of US accountable care.

‘[The contract] is a framework to hurt GP practices and their patients into new PCNs, not the same as current ones. These are different because practices must sign up to a network contract DES, laid over their core GP contract, with a £1.8bn of new network funding and new specifications, like working in multi-disciplinary teams of non-doctors to network protocols, and must sign a network agreement, a new legal integration agreement to enable other providers, such as hospitals, social care, mental health, dentists, Virgin 1 Community Care etc, to become providers.

She added: ‘These new PCNs are the building blocks of the ICSs and work under ICSs, STP direction. They must obey long-term plan objectives to cut spending and commit to shared saving schemes whereby the less hospital care your patients receive, the more money the ICSs make.

‘These structures have never been seen in the NHS before and totally change the GP-patient relationship. Why can’t GPC agree that patient lists, currently owned by GP practices, are taken over and co-owned by ICS all over England? The evolution through multi-year contract change and integration with all medical services fattens ICSs up with ICPs ready for private company takeovers.’

In response, BMA GP Committee chair Dr Richard Vautrey said: ‘The BMA’s GPC has fought and lobbied against the ICP contract since its inception. We’re concerned about it because practices would give up their GMS contract to be part of an ICP contract.

‘The PCN arrangements embed on the GMS contract, retain our independence and ability to advocate for our patients as independent contractors. This contract protects us from the ICP contract. We need it to work and practices around the country are already starting to make it work.’

Pulse previously learned that CCGs in some areas of England have been trying to ‘manipulate’ new primary care networks to ensure they align with their own plans.

It has also emerged that some CCGs have refused to sign off networks where unpopular practices have been left out of the networks.

Earlier this month, Pulse found that London commissioners were trying to impose their preferred size of primary care network on practices after blocking initial proposals.

MOTION IN FULL

Motion by LONDON REGIONAL COUNCIL: That this meeting is opposed to the five-year framework agreement and calls for its withdrawal immediately. It insists that all GPs and trainee GP BMA members must be allowed a vote on it.

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