This site is intended for health professionals only

GP superpractice set to lobby ministers to rewrite GP contractual rules

Exclusive The GMS contract acts as a block to delivering the Government’s plans for GPs to form superpractices, a 100,000-patient GP partnership is arguing.

Suffolk Primary Care, a superpractice that formed in April with 46 partners and 340 staff, is planning to write to the Government to say regulations need updating after a twelfth practice was unable to join its 11-practice merger.

The superpractice, which formed in an effort to ease workload and save money, said this GP practice had to be left out at the last minute because its GMS contract was held by a GP-owned company rather than individual partners.

Paul Brown, chief executive of Suffolk Primary Care, said the partnership is ‘trying to deliver the government strategy in terms of working at scale’ but is being blocked by the legal framework.

The problem has arisen as the superpractice is formed via a joint partnership agreement, but each practice will retain its individual GMS or PMS contract – a model that has been favoured in GPC advice.

According to legal advice provided to the partnership, the rules governing GMS contracts only allow them to be held by groups of individuals – not groups of individuals and a company.

A PMS contract, however, can be held by a mixture of individuals and companies, because the contract itself refers to ‘persons’, which legally includes individuals, companies and partnerships that are a mixture of individuals and companies.

Mr Brown said the nine PMS and two GMS practices that were able to sign the superpractice’s new joint partnership agreement all held their individual contracts as GP partnerships rather than companies.

He said: ‘The problem we are facing is that, by the company-held GMS contract practice signing the comprehensive partnership agreement with other individual GP partners, it makes the agreement void in terms of their ability to hold a GMS contract.’

He added that the issue is ‘acting as a barrier for us continuing to grow and innovate within the system’ and said the partnership plans to write to the health secretary asking for the GMS contract to be amended.

But Dr Richard Vautrey, deputy chair of the BMA’s GP Committee, said these changes to the GMS contract would not be supported by the GPC. 

He said: ‘We don’t support companies holding GMS contracts as it’s important to retain that direct link between GP partners and their patients, which is at the heart of the GMS contract and independent contractor status.’

He added that this position includes companies that are owned by GPs as ‘it would be a fundamental change to the GMS arrangements’.

But he said the partnership should speak with its LMC about ‘other ways for the practice to work in close collaboration with the bigger super-partnership’.

This comes after David Mowat, the former health minister responsible for general practice, said that the current 7,500 GP practices in England may reduce to just 1,500 in future as more practices are encouraged to merge.

The rise of the super-practice

Pulse has been charting the rise of the superpractice, revealing this year that one of England’s largest GP federations is contemplating a merger that could create a 540,000-patient mega-partnership.

It follows a number of other superpractices, including Modality, which counts CQC chief inspector of primary care Professor Steve Field among its partners.

The GPC said in its vision for the future that super-practices could be one of the few ways of ensuring the ‘core principles’ of general practice are retained.

Lakeside Healthcare in the East Midlands told Pulse of plans to launch the largest-ever GP practice in the NHS, with 62 partners, covering more than 100,000 patients.