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GPs should force costly partners to ‘toe the line’ or ‘serve notice’

GPs must ensure their partnership agreements are up-to-date in order to ensure they can take action when a partner refuses to adjust their prescribing or referring habits, a leading accountant has warned.

In a speech at the annual NAPC Conference, Bob Senior, director of medical services at accountancy firm RSM Tenon, said GPs would no longer be able to tolerate partners that refused to change their clinical behaviour in the new commissioning world, because of the financial penalties they could face as members of CCGs if they are found to be outliers in referring and prescribing.

Mr Senior said many older partnership agreements did not allow GPs to crack down sufficiently on partners that refused to comply with the rest of the partners in the practice, and said it was imperative all agreements were up-to-date as the transition to clinical commissioning grew closer, to prevent potentially costly dispute cases that could result.

He said new agreements should be drawn up that give practices the ability to alter the behaviour of partners, or even to remove them from the partnership if they continue to refuse to comply.

He said: 'If you've got a partner that won't change, you need to make sure you've got the mechanism to force that change. Partnership agreements need to be re-written, so if that partner refuses to change, you can make them. The absence of an up-to-date agreeement can make disputes drag on for years, and it will hit your profits, guaranteed.'

'If you have five partners, and one of whom is prescribing or referring in a way the other four are not comfortable with, the other four need a way to make the other partner toe the line. Alternatively, they need to be in a position to serve notice on that partner so if they don't change their behaviour they will be extricated from the partnership. Many partnership agreements don't have that type of clause in.'

'Historically it's been less of an issue because people have been prepared to put up with the behaviour. In future that will hit them directly in the pocket and that behaviour will not be accepted.'

In a speech covering a number of key issues on practice finance, Mr Senior also predicted a tough future for PMS contracts, becase of the potential conflicts of interest that could arise if CCGs are in charge of contract management, or the loss of localism that would occur if responsbility for PMS negotiations goes to the NHS Commisisoning Board. 'I can see PMS being very difficult to maintain,' he said.