Independent GP model must be ‘central’ to neighbourhoods, LMCs demand

The independent contractor model should be ‘central’ to the delivery of general practice within the new neighbourhoods, GP leaders from around the UK have demanded.

On the last day of their conference in Belfast today, LMC representatives voted in favour of a motion demanding that any movement of work from secondary to primary care as part of neighbourhood structures is ‘appropriately’ funded to ensure stability for practices and ‘avoid deterioration to access for patients’.

Proposing the motion, Dr Conor Moore, from Southern Northern Ireland LMC, said: ‘We have already seen in England other organizations being invited into contract negotiations, and the suggestion that trusts could start to hold GP contracts.

‘For now, in Northern Ireland, new structures won’t be able to operate without independent contractors, but we need not forget that this includes pharmacy, optometry, dentistry, care homes, and social care providers. We will all be scrambling for funding.

‘We will see easier work cherry-picked, leaving general practice to manage frailty, complexity, and burgeoning multidisciplinary teams with the risks associated with this.

‘Given the levels of instability in general practice, it’s imperative that GPs and LMCs keep practices clearly informed. It’s essential that LMCs engage with other bodies, PCNs, ICBs, federations to ensure that the needs and practices are appropriately represented.’

Sefton LMC’s Dr David Smith, who supported the motion, said: ‘Neighbourhoods are about providing the right care in the right place at the right time, and while in some economies it may be possible too, practices should not be guilt tripped into signing up for schemes that provide no reward or improve financial security for themselves and their patients, propping up failing services elsewhere in the system.

‘Left shifting should be about transferring all the necessary resources, not sticking plasters over another problem.’

The conference also voted in favour of a motion opposing ‘workforce substitution models’ that ‘dilute’ GP expertise or transfer clinical risk without ‘appropriate’ safeguards.

LMC leaders insisted that GP supervision work is ‘formally recognised as non core’, requiring additional contractual time, funding and indemnity.

The BMA has previously said that in England PCNs should reject proposals to pilot single neighbourhoods if they lack ‘sufficient’ funding.

And NHS England said that new neighbourhood health centres planned by the Government will be expected to include ‘on-site general practice’ as a ‘core element’ of the model, not solely GP staff or sessional input.