England’s LMCs want APMS to be abolished as a contract option for general practice, and for all new contracts to be GMS.
A motion passed at today’s annual LMC conference said conference ‘notes the recent announcements regarding private providers of NHS general practices withdrawing from their contracts’.
It called ‘for an end to APMS as a contractual option for general practice’; and demanded that ‘any new or re-tendered GP core contract is offered as a GMS contract when the successful applicant is able to hold such a contract’.
It also demanded that ‘no funding over and above standard GMS should be provided to commercial organisations wishing to run NHS general practice contracts in England’.
Proposing the motion, Dr Jackie Applebee from Tower Hamlets LMC said: ‘It’s a disgrace that US multi-nationals should be able to play fast and flossie with UK general practice and it must never be allowed to happen again.
‘GMS contracts aren’t perfect but they root general practice in local populations. As Centene and Babylon have so clearly shown there is no place for the private sector in general practice.’
She added: ‘We should have a level playing field. It doesn’t have to be a binary decision, why can’t we just invest in the core.’
Dr Tanya Beer, from Avon LMC, spoke against the motion, saying: ‘APMS contracts provide essential and additional services when GMS practices have opted out. This includes taking over struggling practices who have had to hand contracts back but also contracts that are out of the ordinary such as prison healthcare. In the Bristol area there are many providers who operate APSM contracts.
‘Banning APMS contracts outright without a viable alternative will not safeguard neighbouring practices from the destabilising effects and will lead to a domino effect of practice closures within an area.’
Dr Laurence Heywood, from Devon LMC, had highlighted a ‘risk’ with the last part of the motion.
He said: ‘We know commercially making primary care work is increasingly harder. Sometimes private providers will be given support… and funding. I don’t really support this but if shit is removed without care it risks practices collapsing.’
Dr Francesca Frame, from Cambridgeshire LMC and speaking in favour, said: ‘GMS should be the standard default contract for all general practice providers. What we need is greater investment into the core GMS contract, the struggles of these private providers maybe emphasises the problems we are all facing.’
Motion in full
That conference notes the recent announcements regarding private providers of NHS general practices withdrawing from their contracts and:
(i) calls for an end to APMS as a contractual option for general practice – PASSED
(ii) demands that, any new or re-tendered GP core contract is offered as a GMS contract when the successful applicant is able to hold such a contract – PASSED
(iii) demands that no funding over and above standard GMS should be provided to commercial organisations wishing to run NHS general practice contracts in England. – PASSED
“But if shit is removed without care it risks practices collapsing.”
Never a truer sentence said.
There is no obvious reason why additional services including cover for Prisons cannot be commissioned separately or as a “bolt on” to GMS. To persist with APMS and its inherent lack of transparency will further destabilise GMS.