Exclusive GPs have been left with little time to fill in ‘weighty, unfit-for-purpose’ 210-page contracts to provide enhanced services after CCGs failed to send them out in time, Pulse has learnt.
NHS England has said that the NHS Standard Contract must be filled in by all providers of services to CCGs by 31 March, but LMC leaders have warned that some CCGs have not sent them out yet.
Some CCGs have admitted they have been forced to extend the deadline having only just sent them out, while others have gone against guidelines and issued simpler documents.
GPC has dismissed the contracts – which GPs must fill in if they want to provide enhanced services – as ‘unfit for purpose’, and said that the documents contain impenetrable legal language and are almost impossible to understand.
Pulse revealed at the start of this month that the contracts required practices to appoint a counter-terrorism lead, which GPC leaders described as a ‘pointless gimmick’.
The Standard Contract is being used for all NHS contractors, including large acute trusts and voluntary organisations – but the GPC argues that as small organisations GPs practice require abridged versions.
Local leaders have advised GPs to contact their LMCs before signing the contracts.
But Pulse understands that some CCGs in London, Manchester and Berkshire have not yet sent out the contracts.
Dr Paul Roblin, chief executive of Berkshire, Buckinghamshire and Oxfordshire LMCs, speaking to Pulse at the start of this week, said: ‘In Berkshire the GPs haven’t had the contract at all.’
He added: ‘This contract is so impersonalised and catch-all that it is unfit for purpose. I have had difficulties reading it myself. I have spent hours and hours and I have found so many mistakes. It is a disastrous piece of contracting.’
CCGs in Berkshire and Manchester were unavailable for comment at time of publication and there is no indication as to whether the deadlines will be extended in those areas.
Meanwhile, other CCGs have extended their deadlines.
Heywood, Middleton and Rochdale CCG sent GPs the NHS Standard Contract on March 24, and were the first in the Greater Manchester region to do so. But it has extended the deadline to April 18 following concerns about timescales by Rochdale and Bury LMC.
Lesley Mort, chief officer at NHS Heywood, Middleton and Rochdale CCG, said: ‘We recognise the importance of prompt communication with our primary care colleagues. As such, we emailed our NHS Standard Contract for locally commissioned services to all GPs and pharmacies in the Rochdale borough on 24 March with an extended deadline of 18 April for sign-up.’
Rochdale and Bury LMC secretary Dr Mohammed Jiva said: ‘The problem with these contracts is that a large proportion of them are national and have been drawn up by solicitors who don’t understand primary care.’
‘My worry is that practices will just look at the service specification part and the services they will be providing – and will not read the whole document but sign it good faith. I think the role of the LMC will be crucial in supporting practices, proof reading these documents and highlighting areas of concern before GPs sign them.’
Londonwide LMCs medical director Dr Tony Grewal said that North West London Commissioning Support Unit have given GPs a two-month extension.
The CSU has agreed to use old LES contracts as service specifications to reassure GPs and make the NHS Standard Contract easier to understand, said Dr Grewal.
He added: ‘In North West London they have been flexible about the detail. It has been difficult to understand what this means and what it doesn’t mean. The important thing is to be flexible and pragmatic.’
A spokesperson for Central London, West London, Hammersmith and Fulham, Hounslow and Ealing CCGs said: ‘The CCGs are in the process of issuing NHS Standard Contracts to GP practices for enhanced services with a deadline of 1 April 2014. The CCGs have been working with their practices during this process, recognising that there is a need for flexibility.’
A spokesperson for NHS Brent CCG said: ‘Brent CCG will soon be issuing GP practices with NHS Standard Contracts for services previously delivered through LES contracts. The deadline for completion will be 30 April for most services.’
Dr Robert Morley, chair of the GPC contracts and regulation sub-committee, said: ‘CCGs are being told that any new contract it can issues from practices must be through the NHS Standard Contract. The problem is that it is not fit-for-purpose for contracting with smaller practices. They are impossible for every practice to fill in.’
An NHS England spokesperson said: ‘Providers need to sign contracts before services start to be delivered under them – so, in general, this will mean that commissioners and practices should be signing new contracts by 31 March.’
NHS England has already trimmed down some sections so that GP practices do not have to provide as much information as acute trusts, but is unwilling to make further changes to the nationwide template.
A statement from NHS England said: ‘For 2014/15, the direction of travel towards use of the NHS Standard Contract remains in place. The contract combines nationally-mandated core terms and conditions, with the scope to include locally-negotiated detail such as services specifications and local prices.’
‘Two of the three main elements of the contract – the service conditions and particulars – can be tailored specifically to reflect the range of services being delivered by a particular provider, meaning that the contract for a simple set of community services offered by a practice will be briefer than for a major acute or mental health services provider, for instance.’