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Dozens of GP practices put out to tender under APMS as PCTs prepare to wind down

Exclusive Dozens of GP practices across England face an uncertain future as PCTs prepare to close or retender practices run by their provider arms ahead of the switch to GP commissioning in 2013.

A Pulse investigation reveals the vast majority of PCT-run practices in England have been re-tendered or are in the process of being re-tendered under APMS, in a move that GP leaders have criticised.

Figures from the NHS Information Centre show a total of 84 PCT-run practices remained in September 2010, and our analysis reveals at least two of those are closing and asking patients to transfer elsewhere.

Of 71 PCTMS practices to be analysed by Pulse, two, the Globe Surgery in South East Essex, and the Manzoori Clinic in West Kent, are due to close, while the future of a further eight practices (three in Lincolnshire, two in East Lancashire and three in the North East) is currently being consulted on.

Six practices have reverted to GMS or PMS contracts, while 11 have been transferred to social enterprises formed from old PCT provider arms, and 41 have either been re-tendered or are due to be re-tendered.

Dr Chaand Nagpaul, GPC negotiator, said decisions on potential closures of PCT-run practices had to be taken very carefully: ‘There may be instances where there is not a need but each case needs to be taken on its own individual merit.’

He added that there was no reason why PCTMS practices had to transfer to APMS contracts.

Dr Nagpaul said: ‘There is no compulsion to re-tender under APMS. There are inherent merits to GMS, and also PMS. They are more cost-effective, and provide greater continuity of care.’

One GP who is facing redundancy when his PCTMS practice closes warned that vulnerable patients could be placed at risk by the closures.

Dr Mark Stott, a GP in Westcliff-on-Sea in south east Essex, said his 1,300-patient practice was being shut down.

‘They are going to close it,’ he said. ‘We are a practice for vulnerable patients. We have 1,300, including 400 nursing home patients, many Eastern European patients who don’t speak any English, and homeless.’

‘The plan is to force all of these people into surrounding practices. I am sure it will have an adverse impact upon their care.’

Dr Stott said both he and his practice nurse were facing redundancy and an uncertain future when the practice closes. 

He said: ‘I’m in my early 50s, I don’t know if I’ll get another job after this. I can’t get a partnership because there aren’t any.’

Carolyn Larsen, associate director for primary care commissioning for the NHS South Essex cluster, said the planned closure was backed by patients and other stakeholders.

Ms Larsen said: ‘Patient, staff and clinical opinion is very important to the PCT to ensure patients receive the appropriate care. We have already consulted extensively with patients and stakeholders and our plans take account of their preferred options. ‘

‘A letter has been sent to all patients on the practice list to inform them of the plans, explaining that we are working to arrange for a local practice to take responsibility for providing services for the entire practice list including patients living in care homes.  We shall be able to provide more information when the proper selection procedures have been completed.’

A Department of Health spokesperson said there was no directive from Government to close PCTMS practices, but that it was up to PCTs to decide how best to commission care.

The spokeswoman added: ‘We’ve sent guidance to all SHAs back in January to remind that any PCTMS practices will need to be re-tendered. The guidance is so PCTs don’t get to April 2013 with contracts that aren’t legal anymore.

‘We’re not anticipating any closures – but any closures that might be made would be a decision for the PCTs to take.’



View PCT-run GP practices in a larger map