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GPC challenges decision to open all new GP contracts to competition after legal advice

Exclusive The BMA will write to NHS England calling on them to reverse its decision to only procure new GP contracts using APMS contracts following advice from its lawyers, Pulse can reveal.

The GPC will send a letter to NHS England (London) area team – which was the first area team to publicly announce it was introducing the policy – stating that new contracts should be GMS or PMS, and that NHS England’s stance to only award APMS contracts ‘does not accord with current procurement regulations’.

The letter, which was written following advice taken from the BMA’s legal team, will call on NHS England to reverse its policy, which GPC chair Dr Chaand Nagpaul – writing in Pulse today – warns will ‘destroy the fabric and ethos’ of general practice.

This comes after Pulse revealed that NHS England had called a halt on handing out GMS and PMS contracts, arguing that only APMS contracts comply with procurement law by allowing non-GP providers to compete.

The policy has provoked concern among GP leaders, particularly after Pulse’s Stop Practice Closures campaign found more than a hundred practices who were considering giving up their contracts.

Some have predicted that these closures will lead to a widening of privatisation of practices, as under NHS England’s policy the contracts for these practices would then be reprocured under APMS arrangements.

As a result, GP leaders have urged practices to consider mergers to preserve their GMS or PMS arrangements where there is a risk they may go under.

When Pulse first revealed that NHS England had adopted this stance, the BMA took urgent legal advice and have subsequently identified two areas that they believe exempt GMS and PMS contracts from competitive processes.

Dr Nagpaul writes: ‘NHS procurement regulations, as well as guidance from Monitor, clearly allows flexibility on whether to choose open competition, taking into consideration “securing the needs of patients”, as well as “value for money”.

He explains that APMS contracts don’t satisfy these considerations as they are typically only issued for a five-year period, subject to renewal, and must be procured through costly tendering process.

‘It is unarguable that patients’ best interests are served by secure, long-term dependable local GP services,’ he says.

Dr Nagpaul adds: ‘[Patients] would be appalled to learn of a policy to replace their local GP surgery with a five-year service run by another organisation.’

‘Neither does APMS tick the value for money box. [In recent years] many costly APMS contracts, paid much more per head than GMS or PMS practices, have been decommissioned due to not being cost-effective, or not having delivered on their contract.’

He adds: ‘We will be writing formally to NHS England (London) to withdraw this blanket policy that undermines patient care, and which we believe does not accord with current procurement regulations.’

NHS England (London) area team told Pulse: ‘To allow for greater flexibility of provider, and to comply with international procurement law, APMS contracts are the only contracts that NHS England can offer new or replacement practices.’

‘They are the only contracts that allow for those other than GP practices to bid for the practices.’

NHS England told Pulse: ‘Under the GMS regulations there is scope to enter into a temporary contract but this is at clear odds with procurement law and the 2013 regulations so best practice would dictate that this should not be used when APMS effectively does the same job and does not come with the same risks attached.’

‘GMS can still be entered into upon reversion from PMS and a the new form of PMS contract may be entered into by way of renegotiation (ie variation) but in respect of procurements, yes they should all be on APMS.’