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16,000 patient practice on short-term contract as six APMS providers pull out

A 16,000 patient practice has been left on a short-term interim contract after six of the seven APMS providers invited by NHS England to tender for the contract pulled out saying it was unviable.

The partners at The Mandeville Practice in Aylesbury, Buckingham handed back their contract last year after being unable to replace a recently retired senior partner, and finding locum costs unsustainable.

Since April, the practice has been run by local APMS provider Practice U Surgeries Ltd, on an 18-month contract.

Former partner Dr Gill Beck says it has been left with ‘no security for its future’, adding that commissioners were now getting to grips with how the practice can be run long-term without destabilising adjacent practices.

Local GP leaders said the practice that was no longer viable under the traditional funding model and which would become a ‘poisoned chalice’ if recruitment problems continued.

Speaking on the current state of general practice at the BMA’s Special Representative Meeting (SRM) this week, Dr Beck told delegates: ‘Within 18 months of my retirement from that practice, my partners handed in their contract.

‘Seven private companies came round to look at this, to see if they would take it over. Six withdrew saying it was financially unviable. My practice has gone to a one-year contract with a private organisation with no security for its future.’

Dr Beck told Pulse after the SRM that her remaining partners ‘left because of workload issues and with losing MPIG, it became unsustainable’.

She added that the CCG had recently taken on devolved responsibility for commissioning primary care from NHS England, and were now trying to ‘see what they can do’ without dispersing over 16,000 patients onto neighbouring surgeries.

But Louise Patten, chief officer of NHS Aylesbury Vale CCG said that the retirement of the contract ‘was a chance to commission a service that is more aligned with the Five Year Forward View.’

She added that the consultation with hospitals and GP providers: ‘Is in order to develop a long term solution that takes into account the needs of the local population and offers an innovative and robust solution for patients’.

The Five Year Forward View champions the use of new models of general practice, such as GP-led groups of community care organisations, dubbed ‘multispecialty community provider’, while managers have pledged incentives like ‘simplified’ QOF arrangements to tempt GPs from the national contract.

Pulse has already revealed how an MCP in adjoining Hampshire is putting together a proposal for salaried general practice which could see an entire town switch to an employed model after recruitment issues.

Berkshire, Buckinghamshire, and Oxfordshire LMCs chief executive Dr Paul Roblin speculated the CCG could be contemplating something similar for Thames Valley if the interim provider didn’t work out.

He told Pulse: ‘An MCP is obviously what they’re hinting at, I can’t think of an MCP locally that can take that on. So they’d have to manufacture on from scratch.’

He added: ‘I think they’re desperate to find a solution, there’s no obvious solution for commissioners if you have to run a list based practice and you haven’t got the workforce to do it. It’s almost a poison chalice because no one wants to take it on.’

Stop Practice Closures campaign win

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Pulse has been lobbying for an emergency support fund to protect struggling practices through its Stop Practice Closures campaign.

After initially saying that practice closures were ‘not always a problem’ NHS England annouced last year it would set up a £10m support fund for struggling practices.

Area teams identified over 800 practices that met NHS England’s criteria.

The funding pledged was expanded to £56m for ‘practice resilience’ in the GP Forward View.