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Gerada to ‘start dialogue’ on GPs’ independent contractor status in new NHS England role



Professor Clare Gerada’s new role at NHS England will see her tackle a range of ‘thorny’ issues – including the controversial question of whether GPs should retain their independent contractor status – the RCGP chair has told Pulse.

In an exclusive interview just days after her appointment was announced, Professor Gerada outlined some of her goals as the new clinical chair for primary care transformation in London – a paid, one-day-a-week position she will take on when she steps down as college chair in November.

She said she wanted to discuss how to best deliver integrated care, which will include her ideas for integrated care co-operatives, groups formed of primary, secondary and community care clinicans.

This could also involve examining GPs’ independent contractor status, she added, and moving away from the health service that was designed in the post-war years.

She said: ‘My priority for my first year is around talking to the profession about how we can best deliver services that are in the best interests of our patients and keeping the best elements of general practice – first contact care, GPs’ fingers on the patients’ pulse.’

Professor Gerada said integration was the best way of delivering services in the patient’s best interests and she wanted to start a ‘dialogue’ about how integration should look.

Her own preferred model for integration is ‘integrated care co-operatives’, a concept she explained at an RCGP event on federations last week, which would ‘bring together all relevant health care providers – within a contiguous and geographically bound authority area – as not-for-profit organisations with resources allocated and distributed according to the best needs of the population’.

However, in order to achieve this, ‘it may be that we have to look at some thorny issues’, she added. ‘We may have to examine the independent contractor status and decide what the pros and the cons of it are.’

She added: ‘I am not coming into my new job saying we need to get rid of the independent contractor status – I’m categorically not saying that. I am just saying let’s start to discuss these things and see where it takes us.’

The integrated care co-operatives would not necessarily mean GPs giving up their independent contractor status, she said, but they would make it ‘harder – and I am not 100% sure what the advantages are, although that’s not to say there aren’t advantages’.

Professor Gerada, who has been chair of the RCGP since November 2010, will also take forward NHS England’s ‘call to action’ on reforming GP services as part of her new job.