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Practices’ core funding under threat from PM’s new voluntary contract, says GPC

The GPC has warned practices contemplating the Prime Minister’s new voluntary GP contract that they could lose contractual protection for core services and become vulnerable to takeover.

Guidance released by the GPC said it was not sure whether it ‘will be possible for GPs to maintain a ring-fenced budget for core work’ under the swift movement towards new models of general practice.

It added that the new voluntary GP contract, set to be rolled out to practices with at least 30,000 patients and offering seven-day access from 2017, was likely to be awarded on a time-limited basis only, similar to APMS contracts, which are awarded for a five or ten-year period then put out to competitive tender.

In guidance to LMCs, the GPC said there was uncertainty around ‘how contracts for core general practice services will fit into the new models and, indeed, whether it will be possible for GPs to maintain a ring-fenced budget for core work’.

The new contract being developed by NHS England for multispecialty community providers (MCPs) – which will see GPs taking on secondary care services – is likely to be ‘quite basic’, and there will be a lot of flexibility for local areas. 

’All of these developments have potentially far-reaching implications for GP contracting and service delivery.’

The GPC also warns thatit was ‘likely that LMCs and GPs will be asked to consider moving en masse to new arrangements’.

‘This could include proposals to move away from GMS and PMS contracting arrangements to new local probably time-limited APMS contracts.’

The GPC said its preferred outcome for the new models of care would be if ‘core GMS or PMS contracts could remain separate from wider population-based contracts for other health services, with the contract held directly with the commissioner’.

GPC deputy chair Dr Richard Vautrey said: ‘There’s no doubt that the Government and NHS England plan to roll out new models of care using time-limited APMS-type contracts. Practices need to think long and hard before giving up their current GMS or PMS contract to join in these new arrangements as whatever promises they are given about a supposed return ticket, or short term promises about additional funding, this is undoubtedly a one-way street to larger organisations employing and directly managing GPs.’

He said the new situation was ‘not like PMS practices reverting to GMS’ because new models of care would be ‘radically different’ from the current contract.

He said: ‘New models of care would be radically different and threaten to undermine the long-term commitment that GPs in GMS and PMS practices make to their local community. Instead NHS England should make a clear commitment to building wider community engagement and building comprehensive primary healthcare teams on the foundation of the current GMS and PMS contract not instead of them.’

However, an NHS England spokesperson said: ‘The work is ongoing, [and] we’re very clear that nothing on this issue has been decided on.’

A recent Pulse survey noted that just 12% of GPs would consider taking on the new voluntary contract but the Department of Health has mandated NHS England to ensure half of England’s population is covered by new care models by 2020.

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