GP leaders vote to boycott neighbourhood plans not led by practices

GP practices should be advised to ‘disengage’ from participation in neighbourhood provider structures as set out in the 10-year plan, unless they are ‘demonstrably led’ by general practice, LMC leaders have said.

At their conference in Manchester today, LMC representatives from across England raised concerns that the 10-year plan ‘cannot be delivered without GP leadership’ and voted in favour of a motion insisting that the plan’s implementation ‘must not be imposed by trusts or ICBs’.

They also called on the BMA’s GP committee to advise practices to disengage from participation in neighbourhood provider structures unless they are demonstrably led by general practice, ‘with equitable representation and control’.

Proposing the motion, Dr Richard Van Mellaerts, from Kingston and Richmond LMC, said the 10-year plan ‘seems determined’ to hand control for general practice ‘to anybody but GPs’.

He said: ‘General practice in England is now actively being eaten alive. We’ve moved beyond death by a thousand cuts to wholesale butchery.

‘Control is being handed to ICBs and secondary care trust bodies with no understanding of the value that we deliver every single day to our patients.

‘It’s utterly unacceptable for general practice to be organised or led by anyone other than general practice. This must be agreed nationally, locally, and written in stone in the directions for neighbourhoods and the 10-year plan.

‘We can’t wish away neighbourhoods or the 10-year plan, but we can demand control, clarity and leadership. We can insist that general practice remains led by GPs, locally empowered, nationally supported and collectively strong, because if we lose our autonomy, our independent contractor status, it will be gone for good.’

Devon LMC’s Dr Jamie Graham, who supported the motion, said: ‘We need GPs leading at neighbourhood level, LMCs providing oversight, and funding that matches the ambition.

‘This motion is not obstruction, it’s realism. A plan for the NHS that sidelines general practice is a plan destined for failure. If the NHS wants its plan to succeed, it must work with us. No GP leadership, no viable plan – it’s that simple.’

It comes after Pulse revealed that GP leaders in one area advised practices to hold off from taking part in the new ‘neighbourhood health programmes’, amid a lack of clarity and fears that these could jeopardise GMS contracts.

The 10-year plan announced the introduction of two new contracts as an ‘alternative’ to GMS, aimed at enabling GPs to work across larger geographies, delivering enhanced services for people with similar needs or focusing on services that require coordination across multiple neighbourhoods.

However, the BMA had previously said that the proposal for trusts – and potentially other providers – to take on neighbourhood contracts was ‘a major point of apprehension for GPs’ and could risk bankruptcy for GPs if they were to lose services outside GMS.

Meanwhile, one large ICB has already chosen a number of hospital trusts to oversee the new ‘neighbourhood health service’ across its footprint, announcing that the trusts will also hold the funding.