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GP practices offer to run care homes and discharge services as NHS England’s general practice overhaul begins

Exclusive GP practices across the country have seized the opportunity to apply for £200m of new funding from NHS England, with radical plans to expand into running care homes, day centres and hospitals.

Pulse can reveal the details of several bids submitted by GP practices by the deadline yesterday focus on expanding further into community and secondary care services, and providing better discharge support.

One group of practices hope to cover some 70,000 patients with plans to take over a small community hospital.

Another plans to cover 53,000 patients and build a care home and a day centre for elderly patients.

Successful bids will see practices gaining ‘vanguard status’ and being allocated a chunk of the Government’s one-off £200 million fund aimed at ‘kickstarting’ the new models of general practice described in NHS England’s Five Year Forward View.

The document urged GP practices to consider becoming ‘multispeciality community providers’ that would allow them to combine with other community services, hospital specialists, mental health and social care ‘to create integrated out-of-hospital care’.

The Whitstable Medical Practice in Kent is teaming up with two smaller nearby practices into a federation covering 53,000 patients to apply to become one of the chosen pilot sites. It is planning to use any money allocated to set up a new community hospital, a nursing home and an ‘extra care facility’ for frail elderly people that will include a day centre.

Dr John Ribchester, a partner at the practice and a member of the governing body of NHS Canterbury and Coastal CCG, said: ‘The whole concept is to try to produce an end to silo working and a much more connected health and social care offering for the population that the three practices serve.’

In Wessex, LMC chair Dr Nigel Watson is a partner at one of seven GP practices that are teaming up with a small community hospital to set up an extended service to some 70,000 patients, including the frail elderly, mental health, and older people’s mental health.

Dr Watson said: ‘Working with the voluntary sector and the local authority [will] also make general practice more sustainable in the long term, to produce a better career structure for young GPs, retain older GPs, and make better use of people’s skills – but [also] maintaining the strength of the registered list and general practice as it sits today.’


He added: ‘There is lots of interest in developing this and seeing as a way forward potentially to get new resources to help outside hospital care. I know of at least five other bids in Wessex that are being talked about.’

Middleton GP Dr Mohammed Jiva, secretary of Rochdale and Bury LMC, said they were looking carefully at the interface between primary and secondary care. He said: ‘We’re looking at early discharge schemes – in terms of helping patients get out of hospital sooner and trying to avoid admissions from A&E in the first place.

‘It would do a couple of things: one, it would allow discharge of patients earlier, knowing that there is a system in place in the community to look after the tail end of their care, which frees up a hospital bed, allowing those that need to be in hospital to get admitted.

‘Secondly, it would also ensure that what goes to A&E and is assessed and managed by A&E is appropriate – and that what isn’t appropriate is referred back into the community with a GP appointment. So there’s a big element of patient education and knowing what services are available locally, and that A&E isn’t the first port of call for minor ailments.’

Elsewhere, NHS Dudley CCG said it has made an application that would see GP-led MCPs of integrated services across health and social care created to serve 60,000 patients, as part of ‘a wider network of care’ operating at a population level of around 300,000. A spokesperson it is ‘establishing the mechanism for commissioning best practice pathways of care for treatments that can’t be undertaken from within the core model of provision’.

NHS Hardwick CCG has also applied to become a pilot site, with a bid including 16 member practices with a combined patient base of 102,000 people, that will provide extended primary care via community hubs.

The applications come as hospitals prepare to make inroads into primary care. Pulse revealed last week that hospitals were already recruiting GPs to join them and prepare to become the ‘primary and acute care systems’ also described in the Five Year Forward View.  

NHS England declined to comment on how many applications it has so far received.

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