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Practices may be able to retain GMS alongside new voluntary contract

Large groups of practices that take up the Prime Minister’s alternative GP contract in 2017/18 may be able to retain their GMS contracts, Pulse has learned.

One of the groups involved in developing the contract has told Pulse that they are looking for it to be based on patient list sizes, which would allow practices to retain their current contracts with the voluntary contract paying them more for providing a wider range of services.

They would also receive greater funding for ‘outcome measures’ based on the quality of the services they offer.

The contract was announced by David Cameron last year, and will apply to the ‘new models of care’, which will provide primary and secondary care services to populations of more than 30,000.

This will include funding practices to provide seven-day access.

Currently, there is little detail around what the contract will entail.

However, Paul Maubach, chief officer for NHS Dudley CCG, has told Pulse that the contract is likely to be based on patient list sizes. 

His CCG is developing a multispecialty community provider (MCP) – the new models of care led by GP practices – which spans all the GP practices in the CCG area.

He said that the new contract needed to provide MCPs with a set budget based on capitation, rather than ‘itemised’ – ie, based on the number of procedures they carry out. 

However, it would also include an element of ‘outcome measures’, increasing funding based on the quality of services.

Mr Maubach said: ’At the moment we pay for a lot of services on an itemised service basis and I think the key intention with the MCP contract is to move to a basis where we fund services on a capitation basis linked to a set of outcome measures… What we are looking to do is move to more services to be funded on a capitation basis, linked to outcome measures.

’The one set of services that are [already] funded in that way at the moment are the GP services under the GMS contract. That is a capitation based contract. And when you include the QOF, it is funding based on outcomes measures.’

’What we are looking to achieve via the MCP is to expand that, to include a much wider range of services… so community based services, mental health services etc.’

He said that therefore the new MCP contract and the GMS contract were ’not necessarily mutually exclusive’ and therefore ’one doesn’t necessarily replace the other’ but that the ’two can work, and need to work, in parallel’.

One way this could look would be for a federation to hold an MCP contract and each GP practice a GMS contract.

He said: ‘That is one possible scenario. It would be short-sighted to say today that MCP is going to replace GMS. That is not what this is about. It is about how you get a way of working that complements general practice and enables general practice to work better together. I see it as a complementary process rather than a replacement mechanism.’

GPC deputy chair Dr Richard Vautrey said: ‘We’ve been strongly encouraging the group to develop a model of MCP contract that can be used with a GMS contract not instead of it. This would provide stability to practices and patients alike.’

An NHS England spokesperson said: ‘We will be publishing a document setting out the latest thinking on the MCP model and contractual arrangements shortly.’

Developing a new GP contract

Prime Minister David Cameron announced his new outcomes based GP contract last year, saying it would include seven-day access and be offered to practices or federations covering at least 30,000 patients.

The Prime Minister said the contract would ‘get rid of the box ticking and the form filling’ because he did not ‘think anyone is happy with the GP contract’.

But at the time, the GPC said that GPs did ‘not need the diversion of a new contract’, and earlier this year it warned it was putting GP core funding under threat and opening up for takeovers.

Developing the MCP contract forms part of the Department of Health’s mandate to NHS England for this financial year, so it can be rolled out from next April.

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