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GP practices looking to merge with hospital trust to ‘de-risk’ future



Exclusive Up to five GP practices are looking to offload staff and have their properties bought by the local hospital trust in order to stay open, Pulse has learned.

The long-term aim is for the local Southern Health NHS Foundation Trust-led Multispeciality Community Provider (MCP) ‘vanguard’ to be directly contracted to provide GP services – something which is not currently possible under GMS arrangements, the MCP’s GP clinical lead said.

In the meantime, one practice in Gosport has nearly finalised merger negotiations that will see two GP partners forming a new provider arm with Southern Health, while the trust will take over employing all the other practice staff and the leasehold for the practice premises.

And, according to Southern Health, up to five practices are seeking similar agreements with the same trust, in the face of increasing demand and a shrinking GP workforce. A trust spokesperson said ‘a handful’ – clarified as ‘three or four’ – other practices had expressed interest in such a move.

The MCP vanguard spans 30 GP practices across South Hampshire, the majority of which remain independent contractors. NHS England’s new models of general practice vanguard programme includes GP practices and hospitals working together in larger organisations providing both primary and secondary care. Aside from the MCP model, nine hospitals have been approved to pilot directly providing GP services under the vanguard scheme, prompting GP leaders to warn practices may be ‘devoured’ by hospitals.

But Dr Donal Collins, a GP in Fareham who is clinical lead for the vanguard led by Southern Health, said the trust was ‘de-risking the job’ for GP partners so that practices could survive and sustain services for the local population.

Dr Collins said: ‘Essentially they are looking for a way of de-risking the job, taking the property out of the equation, having a guaranteed, reasonable income.

‘Southern can then put other people in the practice because they have access to physios, community psychiatric nurses and so on, who can see patients and with the multidisciplinary approach and then the practice can survive.’

The new arrangement with the Gosport practice, which serves around 9,500 patients, involves some of the GP partners forming a ‘shell company’ with Southern Health that will hold the GMS contract, as the trust cannot legally take over a GMS contract itself.

The remaining practice staff – both non-medical and medical – will become employees of Southern Health. The spokesperson for the trust said negotiations with the practice ‘are progressing well’, and were ‘aiming for October implementation’.

Dr Collins stressed the trust arrangement was not seen as a long-term solution for practices in the vanguard area, and that the MCP would aim to form an organisation to hold GP practice contracts in future.

He said: ‘We need to find a way so that ultimately these practices will come within the MCP – so Southern’s strategic view is they are essentially holding and minding them until the MCP is in such a shape it can take on these practices within the bigger organisation.’

He said that the MCP taking on practice premises forms a key part of the plans, and in the case of the Gosport practice will mean the trust taking over the practice leasehold.

Dr Collins said: ‘The risk was the practice could have gone under, and then individual partners would be liable for rent on empty building.

‘One of the plans for MCP would be for those who want to give up lease, or MCP would invest in owner occupied premises, then create a stronger primary care at scale.’

Southern Health has already signalled its willingness to help rescue GP practices in need, having signed up to NHS England South’s formal panel of providers contracted to temporarily take on the running of GP practices having to close at short notice, but the arrangement with the practice in Gosport is intended to be permanent.