The GPC has pledged to fiercely resist Government plans to overhaul the GMS contract to incentivise integration between GP practices, claiming the move would erode the independence of GPs and pave the way for a ‘corporate model’ of general practice.
The DH said it would charge the NHS Commissioning Board with exploring ways of incentivising integrated working between practices in future GMS negotiations, as GPs have an ‘increasingly important role’ to play in treating patients with complex needs as the NHS shifts more care to community settings.
But the GPC said it would resist the move in contract negotiations, and said using the contract to push practices into models of working was ‘unnecessary’ and ‘inappropriate’.
The DH report states: ‘The board should explore how to incentivise integrated care in General Medical Services contract negotiations.’
In its report on its second phase of work, the NHS Future Forum stopped short of specifying how GP practices should be incentivised to work together via the GMS contract, but did strongly back the federated model of care promoted heavily by the RCGP at the time when current NHS Future Forum chair Professor Steve Field was college chair.
‘A federation of practices acting together enjoy economies of scale that lead to valuable efficiency gains which allow them deliver a wider range of services for their patients, and are able to play a much greater part in delivering accessible integrated care for the local population,’ the report said.
‘There is growing evidence that groups serving a population of approximately 40,000 to 70,000 will be best placed to realise the benefits of the federated model.’
But Dr Richard Vautrey, deputy chair of the GPC and a GP in Leeds, said: ‘There are already ways in which practices are cooperating with one another for the benefit of patients. To focus on the GMS contract as a vehicle for doing that is inappropriate and far too narrow a view. The GMS contract is with individual practices, not a group of practices.’
‘What practices do not wish to do is lose their independence within a group of practices with whom they work. They don’t want a corporate model of general practice run by a small group of entrepreneurs.’