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Private firms prepare major initiative on GP commissioning

By Ian Quinn

Exclusive: A group of leading private companies is planning a major joint initiative to persuade GP consortiums to partner up with them, on the back of the Government's White Paper on health, Pulse can reveal.

UnitedHealth UK, Tribal, Humana, Bupa and Aetna UK are drawing up a framework of potential services GPs will be able to ‘buy in' from the private sector, with companies taking on a share of the commissioning risk.

They are confident the White Paper will hugely increase the scope for private firms, with one leading player claiming it will lead to the full 'denationalising' of healthcare in England.

Groups of private healthcare insurance, financial services and IT companies will offer GPs a raft of commissioning support services, following moves to hand them control of £80 billion of NHS cash.

These will include medicines management systems, IT systems, commissioning-support tools, back-office support and patient-management services, many of which have already been used by PCTs under the previous Government's FESC framework and via individual deals with private firms.

Now the group of private companies, working with undisclosed leading financial companies, are turning their attention to GPs and will be offering to share the financial risk involved in setting up new consortiums, in return for potentially lucrative contracts.

However, they will also carry out tough vetting of potential GP partners.

The White Paper sets out plans to provide GPs with a maximum management allowance, including premiums for those who achieve high-quality health outcomes and for financial performance.

But Kingsley Manning, director of Tribal, told Pulse: ‘My guess is that the management fee will be fairly modest and that it will mean the way that GPs will be able to run this is in a collaborative approach.'

He said offering GPs a chance to share the risk of the new ventures would be a major part of the private firms' strategy, following health secretary Andrew Lansley's warning of no ‘bail out' for consortiums that fail.

‘We're working on the assumption that there will be some element of risk transfer. Risk management is going to be a very, very important factor.'

‘There is undoubtedly some sense that there should be some pain involved. But by working together, private health companies believe they can draw up a series of packages which will not only be highly attractive to GPs looking to reduce costs and share the risk of failure, but fit what are expected to be ultra-tough quality standards demanded by the new independent NHS Commissioning Board.'

Mr Manning said Mr Lansley's plans could lead to the ‘denationalisation of healthcare services in England', adding that the White Paper ‘represents the most important redirection of the NHS in more than a generation, going further than any Secretary of State has gone before'.

‘The old certainties are gone: the NHS cannot be protected from economic reality any longer,' he added.

He said that Tribal hoped to have its offer to GPs ready by the autumn when the Health Bill goes before parliament, and that each of the major companies would also be working with their own unique business partners.

‘We don't want to give the impression that GPs are being strong-armed into working with us. They are of course free to do this themselves and indeed we will be fairly cautious as to who we work with. We won't just be jumping into partnerships.'

The White Paper says: ‘GP consortia will need to have sufficient freedoms to use resources in ways that achieve the best and most cost-efficient outcomes for patients.

‘GP consortia will have the freedoms to decide what commissioning activities they undertake for themselves and for what activities (such as demographic analysis, contract negotiation, performance monitoring and aspects of financial management) they may choose to buy in support from external organisation, including local authorities, private and voluntary sector bodies.'

The Government has also unveiled plans to ditch Labour's ‘NHS as the preferred provider' policy and switch to a principle of any willing provider, which will reduce the barriers to private firms.

Tony Sampson, director of external affairs at UnitedHealth UK, said: 'There's no doubt that the Government is putting GPs and primary care at the heart of its reform agenda for the NHS. The work we've been doing with GP commissioning groups has been to provide a series of support services, such as analytics, evidence based techology and contracting support. The opportunity to combine this with GPs' understanding of individual patients' needs provides a great opportunity to improve outcomes for patients and provide cost effective care.'

Although not involved in the new trade body, Virgin-owned Assura Medical, which runs 15 Darzi centres in England and has 30 GP companies involving 1,500 GPs, also said the White Paper would open up new opportunities, saying the plans ‘closely match its business model'.

'We are enthusiastic about the reforms proposed by the Government's health White Paper, said Bart Johnson, chief executive of Assura Medical.

‘GPs are crucial to the provision of services and are well positioned to manage the resources available to enhance patient care. We see this as a good opportunity to build upon our current work with GPs and the NHS to improve health outcomes for patients."

Shadow health secretary Andy Burnham, who brought in the preferred provider policy while in Mr Lansley's hotseat, described his successor's plans as giving ‘the green light to let market forces rip right through the system with no checks or balances'.

He told the Commons: ‘Is not the handing of the public budget to independent contractors tantamount to the privatisation of the commissioning function in the NHS? Will there be any restrictions at all on the use of the private sector by GPs?'

Kings Fund chief executive, Professor Chris Ham, said the White Paper would ‘accelerate the trend' towards further privatisation, adding that it would lead to ‘opportunities for private companies to support GP commissioning and increased opportunities for independent providers to deliver treatment'.

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