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GP practices will need to give one year’s notice to exit new ‘voluntary’ contract



GPs will have to wait at least a year to leave any new ‘voluntary’ contract after giving notice of their decision to do so.

This forms part of proposals in a Department of Health consultation on changes to the GMS and PMS contracts that will be necessary to facilitate the new multispecialty community provider (MCP) contract. 

Pulse previously reported on draft guidance for the new 10-15-year contracts, due to become available from April next year, which said that GPs have a right to return to their contracts in two-year intervals after joining an MCP.

The guidance said that if the practices were more than two years into the voluntary contract, their patients would not follow them unless the patients themselves specifically requested to.

However, the proposed amendments to the GMS and PMS legislation add that the date from which the GP would like their contract to be reactivated ‘must be at least twelve months after the date on which the notice was given’ to leave the MCP.

Dr Robert Morley, GPC contracts and regulations lead, said that for GPs to wait a year ‘is indeed a long notice period’.

However, he said the risk that practices take in suspending their contract is ‘of even greater concern’, despite their right to reactive the contract. 

He said: ‘In effect all that the original practice retains is the right to hold the contract; the business of the practice and its patients are lost and have to be won back.’

He cautioned practices to ‘think very long and very hard about the implications, risks and potential consequences’ before joining a voluntary contract.

NHS England guidance last year said GP practices could hold virtual, partial and fully integrated MCP contracts – only the latter which would see their contracts replaced.

The BMA’s GP Committee has advised practices to not ‘make any hasty decisions’ with regards to MCPs, and to not to feel pressured to give up their GP contracts.

NHS England’s definition of a multispecialty community provider (MCP)

MCPs will ‘combine the delivery of primary care and community based health and care services’ including ‘planning and budgets’ while also incorporating ‘a much wider range of services and specialists wherever that is the best thing to do’.

Key features of the ‘fully integrated’ MCP model include:

  • Holding a single whole population budget across the range of services it provides, based on the GP registered list – the MCP covers the sum of the registered lists of the participating practices, plus the specified unregistered population;
  • Built around ‘care hubs’ of integrated teams, each typically serving a community of around 30-50,000 people (but NHS England says that all the 14 MCP vanguards now serve a minimum population of around 100,000);
  • A place-based model of care which serves the whole population, not just an important subset such as people over the age of 65;
  • Operates at at the whole population level, aiming to ‘bend the curve of future healthcare demand’ by addressing ‘the wider determinants of health and tackle inequalities’;
  • Builds a ‘coherent and effective local network of urgent care’ for people with ‘self-limiting conditions’;
  • Provides ‘a broader range of services in the community that are more joined-up between primary, community, social and acute care services, and between physical and mental health’ for people ‘with ongoing care needs’;
  • Delivers an ‘extensive care’ service for ‘small groups of patients with very high needs and costs’.

Source: NHS England