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GPs miss out on £85m sexual health contract



Exclusive GPs have lost out on an £85 million contract to provide sexual health services in one part of the country, and will instead have to subcontract services from a ‘lead provider’.

Birmingham City Council has shortlisted providers for a new sexual health service, which combines all existing contracts – including general and specialist GUM services, STI screening and former GP local enhanced services – into a single five year contract.

The contract winner will act as ‘lead provider’ and Birmingham City Council intends for them to work with practices, as well as pharmacies and hospitals, to deliver sexual health services in future.

The council confirmed that no GP organisation had made it onto the shortlist, meaning the contract will likely be held by a local foundation trust or a private provider, local leaders warned.

GP leaders said this form of contract was a ‘world of difference’ from the current provision for patient lists.

John Denley, commissioning lead for sexual health services at Birmingham County Council told Pulse that the benefits of commissioning all sexual health services through a single, lead provider were ‘easy to establish’.

He added that GPs had a good track record in delivering sexual health services, but hoped the lead provider would find ‘more opportunities to deliver services in general practice.’

The council hopes the eventual contract winner would help to shift more sexual health services from secondary care into general practice.

Mr Denley said: ‘It’s a competitive bidding process, it’s not a “fill your boots up to £85m” it’s about the best quality bid, at the best price.’

‘We are lumping it all together, it is going to be a single system and the benefits of a single system are easy to establish. We had so many different contracts, 20 plus contracts, and around 90 contracts with general practices in Birmingham to deliver sexual health services. Each of those contracts were in singularity, so there was no way of the systems talking to each other.’

He added a single provider would help to standardise service quality, saying: ‘There’s such a variation in quality across general practices, what we want a lead provider to do is get a grip on that, make sure we’re all working to the same quality.’

‘So patients and clients of the sexual health system in Birmingham will experience the same standard of care, at the highest quality, right across the board.’

But Dr Robert Morley, executive secretary of Birmingham LMC and chair of the GPC’s contracts and regulation subcommittee, has warned that there’s a ‘world of difference’ between being subcontracted to a third party, and the way these services had historically been delivered.

Dr Morley told Pulse: ‘[I understand the council] are seeking the contractor to enter into some sort of sub-contracting arrangement with GP practices, so that work can still be delivered through GP practices.’

‘Which is encouraging in a way, but there’s a world of difference between that and the historical situation where-by general practice has provided this work holistically to its registered patient list.’

‘We don’t know what the new arrangement is going to be like, it depends which organisation wins the contract, and clearly with something this size only a very, very large organisation is going to be in a position to bid in the first place.’

‘I imagine the favourites will be either large foundation trusts or very large commercial entities.’

And Dr Morley confirmed that the local GP practices that there hadn’t been a successful GP-led bid to be the contract provider, but said he was ‘hopeful’ that GPs might have some influence.

He told Pulse: ‘Sadly what has happened is they, and the GP-body as a whole, hasn’t been able to get their act together to have the single sort of bid.’

‘There’s a possibility, and certainly there was an attempt to get a single, GP-led bid off the ground. But because of different groupings of practices in co-ops, and so on, it hasn’t been possible to get a united GP-led bid.’

‘Which means that inevitably the successful bidder will not be a GP led organisation, though I’m hopeful there might be some GP influence with it.’

Competitive tendering for services has become a major concern for practices and GP leaders, who believed it could ‘destabilise’ practices and the professional bodies even warned competition could ‘reduce’ patient choice.

However Pulse has recently revealed that practices have been granted a reprieve in many cases, with a third of CCGs saying they would review services this year before making final decisions on whether to use competition.

Several regions are using that time to form GP federations or provider companies, and Pulse survey earlier this year revealed that a fifth of practices were contemplating some form of GP alliance after fears that single-handed practices would lose services to large private providers.