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NHS England launches consultation on ‘voluntary’ new care models GP contract



NHS Dudley CCG is to pilot the latest version of NHS England’s new integrated care model contract following the launch of a consultation on the national plans.

Previous attempts by Dudley CCG and other regions in England to test earlier versions of the contract were thwarted due to the late publication of guidance and debates by GPs over which type of contract to sign.

The twelve-week consultation, which began on Friday, comes after two judicial reviews ruled in favour of NHS England’s plans to implement ‘integrated care organisations’ (ICO) – previously called ‘accountable care organisations’ – earlier this year.

The most recent judicial review, which was overturned last month, called on the Department of Health and Social Care to consult the public about the plans. The Government had already committed to doing so, in January – before the judgement had been handed down.

According to the consultation document published last week, NHS Dudley CCG is at the ‘forefront’ of integrated care and will be able to implement the draft voluntary contract ‘subject to the outcome of this consultation exercise’.

Paul Maubach, chief executive officer of NHS Dudley CCG, said the contract ‘is an extremely important innovation’.

‘Through our local work, we have been able to contribute to the development of this proposed contract and subject to the outcome of the consultation, we will be a national pilot by using it to contract for our own ICP [integrated care provider] – the Dudley Multispecialty Community Provider.’

Earlier this year, Pulse revealed that all 45 practices in NHS Dudley CCG and four hospital trusts will form a new foundation trust to hold the multispecialty community provider contract, worth £5bn, to provide primary and community care services together. 

Under NHS England’s draft plans, GPs will be able to sign ‘fully’ or ‘partially’ integrated contracts – with ‘fully integrated’ practices giving up their GMS and PMS contracts to become salaried.

Pulse has previously reported that GPs taking part in this type of ICO could be forced to give up their patients if they chose to return to their previous contract after more than two years.

Meanwhile ‘partially integrated’ agreements between GPs and their local ICO will see practices retain their contracts. 

The consultation document maintains that GPs will be required to give 12 months’ notice if they wish to leave a ‘fully integrated’ ICO, despite criticism from the BMA that this length of notice period is ‘not appropriate’, and that ‘a three-month period would be sufficient’.

While the consultation document said that ‘no GP will be required’ to sign a new care model contract in any form, it added that GP participation is ‘vital to deliver integrated care’.

The document added: ‘But the participation of any individual practice or GP is entirely voluntary, and the manner in which they integrate with an ICP will be for them to decide.’

NHS England’s moves toward integration

This month’s consultation is the latest iteration of NHS England’s integrated care contracts, initially called ‘vanguards’, which were first launched by former Prime Minister David Cameron in 2015.

A total of six multispecialty community provider (MCP) vanguard pilots, including Dudley, were supposed to launch in April 2017 but faced delays while GPs debated which type of contract to sign and draft MCP contract guidance wasn’t released until December 2016.

However, this guidance was updated in August 2017 when NHS England released the accountable care organisation guidance, which further fleshed out the ‘voluntary contract’ while including all other health and social care organisations.

NHS England rebranded accountable care organisations into ICOs in the ‘Refreshing Plans’ document released in February.