ICB likely to put GP contract out to tender despite patient protests

An ICB looks likely to put an APMS contract out to competitive re-tender, despite patients expressing a preference for keeping their current GP.

Lancashire and South Cumbria ICB had already awarded the Withnell Health Centre contract to another provider – SSP Health – last year. However it decided to extend Dr Ann Robinson’s APMS contract following patient protests, including hundreds of letters.

At the time, Dr Robinson, a partner of 11 years at the Chorley practice, said the public were not properly consulted and hosted multiple protests at the practice demanding a review of the procurement process.

She was successful, with the ICB agreeing to re-run the process for the contract and extending the interim arrangements until 30 September this year, while it conducted a review – including regarding public engagement.

However a document that has been shared ahead of the ICB’s primary care committee meeting this Thursday – where a decision will be taken on the practice’s future – indicates that the APMS contract will again be put out to a competitive re-tender.

The document said: ‘It is recommended that, based on consideration of procurement routes and associated published guidance, the committee approve a competitive procedure under the Provider Selection Regime (PSR) in accordance with the timeline previously agreed.

‘In recognition of the recent market engagement exercise, it is considered that the competitive procedure provides a more proportionate, timely and similarly robust process to choose a provider.’

This comes despite a survey of 2,500 people, carried out by the ICB as part of its review into the process, having found that 62% thought ‘there was nothing wrong with Withnell Health Centre’.

The survey report, shared ahead of the committee meeting, said: ‘Responses were overwhelmingly positive towards the current management of the practice. Almost all said they were very happy with the practice currently and did not want to see any changes to the running of the surgery.

‘It is worth noting that while 62% stated there was nothing wrong with the practice, an additional 4% commented that the current uncertainty of the future was the main issue currently facing the practice.’

The report also said that patients ‘value the relationship built with Dr Robinson over a number of years’ and ‘have high praise’ for the standards of care provided by the current team at Withnell Health Centre.

According to the ICB document, patient feedback referred to the procurement plans as an ‘absolute waste of time’ when patients ‘want Dr Robinson to stay’.

The document said: ‘While feedback was overwhelmingly positive, some survey responses indicated that there were some concerns about issues such as access to appointments, the number of locum GPs currently working at the centre and concerns about the practice reception.

‘However these concerns were hugely outnumbered by the number of patients stating they were happy with the practice as it currently is.’

Dr Robinson said ‘it is unbelievable that anyone would think’ that this process was ‘a good way to spend taxpayers money’ especially during a cost-of-living crisis.

She claimed to have seen FOI responses showing that the last bidding round ‘cost the ICB £200,000 in legal fees alone’, however the ICB refuted this figure to Pulse.

‘Our patient satisfaction scores stand at 97%, we consistently deliver excellent, community focused care and same day access,’ Dr Robinson said.

‘Going out to tender causes more stress and uncertainty for staff and patients.

‘Once again my staff are worried about their jobs, and the community is concerned about the future of their health centre.’

According to Dr Robinson the ICB should be able to ‘directly award the contract, “if there is compelling evidence” to do so’.

‘I would argue that feedback from over 50% of our registered population is compelling evidence,’ she said.

However Lancashire and South Cumbria ICB told Pulse that this option is only available if ‘the proposed contracting arrangements are not changing considerably the existing contract’. 

It argued that: ‘The threshold for considerable change is breached as the lifetime value of the proposed new contract is more than £500,000 higher (it is £7,474,000 higher) and also it is more than 25% higher (it is 527% higher) than the existing contract.’

Its chief operating officer Craig Harris said that the ICB is ‘committed to securing the best outcome’ for Withnell Health Centre and its patients.

He told Pulse: ‘We would like to reassure our local population that securing high-quality services for them remains a priority for the ICB.

‘Over the past 10 months we have been working closely with members of the community to keep them updated on the situation.

‘The ICB has worked in partnership with a patient steering group who have contributed to developing an engagement process and shared views to support a new approach to be used for all future primary care procurement in Lancashire and South Cumbria. The ICB has appreciated the support and close partnership working with patients of the practice.

‘A decision on the approach to be taken in relation to the procurement option is expected to be made at the primary care commissioning committee meeting on Thursday.

‘We are committed to securing the best outcome for Withnell Health Centre and its patients within the legal guidance we are required and permitted to consider.

‘It is important to note that the ICB has not made any decisions yet, this will be a committee discussion in public and we need to follow due process for equity and fairness. Until this decision has been made, we aren’t able to comment any further.’

In November, England’s LMCs voted in favour of a motion proposing to abolish APMS as a contract option for general practice, and for all new contracts to be GMS.