10-year plan could ‘seriously undermine’ current GP model, BMA warns
The BMA has raised concerns that the 10-year plan could ‘seriously undermine’ the current GP practice model, revealing that its GP committee had not been allowed to see the plan ahead of publication.
GPC England chair Dr Katie Bramall said that committee members are currently ‘working through the plan’ but that they were not given the opportunity to ‘see it or contribute to it’ before it was published last week.
She warned that the plan points to ‘potentially profound changes’ to general practice, which could seriously undermine the current practice model and the continuity of care that patients rely on.
As part of the plan, the Government will introduce two new contracts aimed at enabling GPs to work across larger geographies and will offer ‘an alternative’ to the traditional GP partnership model but could also be offered to acute and community trusts.
It comes after health secretary Wes Streeting argued that as part of a radical reform of the NHS, acute trusts should be able to provide primary care services and that ‘successful GPs’ should be ‘able to run local hospitals’.
The BMA is currently in negotiations with the Government for a new wholesale GMS contract to come into force by 2028, which would be the biggest set of reforms to general practice in two decades.
Dr Bramall said: ‘We are working through the plan, having not been given the opportunity to see or contribute to it ahead of publication.
‘The BMA’s GP Committee for England will meet in the coming weeks to consider the many questions we intend to put to the Government.
‘While the plan contains several aspirational ideas, we need detail and funding for the new GP contract to be delivered within this Parliament as per the Secretary of State’s written promise of 18 March.
‘What we can already see is that the plan points to potentially profound changes to general practice, changes that, in some instances, could seriously undermine the current practice model and the continuity of care that patients rely on.’
The plan also included an emphasis on training GPs over hospital doctors, after the chancellor specified GP training as a priority investment area in long-term spending review and promised to train ‘thousands more GPs’.
Dr Bramall said the announcement of more GP training places was welcome, but that solutions for the GPs who face under and unemployment are needed ‘today’.
‘This issue must be addressed urgently as within the next four weeks, thousands of newly qualified GPs complete their CCT and will seek to enter the workforce,’ she said.
She added that there will be ‘significant discussions’ required around the use of confidential patient data which GPs oversee as data controller.
It comes after the plan announced that the NHS will introduce a ‘single patient record’ (SPR) available on the NHS App by 2028, bringing a patient’s medical records and other relevant information into one place, and introduce new legislation placing a duty on providers, including GP practices, to make the information they record about patients available to them.
Dr Bramall said: ‘That is a role GPs oversee very carefully, and we will need solutions enacted, such as NHS Resolution widening indemnification to protect GPs from any potential data governance breaches that come about due to government policies.’
The BMA has recently raised concerns about plans to transfer some ICB functions to neighbourhood teams, saying that these pose an ‘existential threat’ to GPs as independent contractors.
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READERS' COMMENTS [7]
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What exactly is this “current GP model” we’re supposedly protecting?a handful of PCN Clinical Directors and GP Partners oversee a rota of nurses, ANPs, PAs, and salaried GPs—while reserving a few token appointments for themselves while pocketing massive profit for themselves?
What is the reason for producing a massive number of new GPs, when there is big unemployment of GPs?
Is it to force the payment rates even lower?
Is it to force emigrantion of qualified GPs to a specific country that has bribed the UK to produce them?
It is not to provide better GP service to patients, that’s for sure!
Whereas there are some good things in the 10 year plan, from a GP partner perspective, there needs to be a lot more detail in what is going to be done to help support or protect or improve recruitment/retention into the partnership model which, the plan states, the new contract models are not going to replace. How will they encourage more GPs into partnership, how will they address the liability. If we are having these bigger centres-how will that fit with building ownership currently. All of these questions, and more, which are valid for the finances of GP partners who currently hold all the liability. This seems to be lacking in the 10 year plan and also in the BMA rhetoric. It makes it seem as though they are hoping we will all sleepwalk into these larger provider contracts. GP partners are very innovative and open to development, but we also have personal finances to balance. (Comments from J S being very uninformed and unhelpful). Lots of great stuff in the 10 year plan but work with the GP Partners closely to help prevent the catastrophic personal impacts that may occur.
Many in DHSC do not know or understand about the unlimited liability ( including a previous Secretary of State). I doubt this has been factored into their plans..
Come on BMA, follow the resident drs lead. Call strike action and peaceful protest….the 10 year plan is riddled with neoliberal philosophy and written for the interests of corporates and oligarchs, not for patients, taxpayers or citizens.
“PCNs are now bidding for the 10-year neighbourhood contracts, which raises serious concerns. The same Clinical Directors and Partners—many of whom are already profiting handsomely through the mass hiring of PAs and salaried GPs—will now control these neighbourhood contracts as well. Despite a so-called ‘workforce crisis,’ there are virtually no partnership vacancies across England today.
So how will these contracts be delivered? Likely through even more salaried GPs, further entrenching a model where Partners earn £300k to £600k annually while others carry the workload.
What’s more baffling is the concept of ‘unlimited liability’ being used as a barrier to PCN Clinical Directorship. Why shouldn’t every qualified GP be eligible to become a PCN CD? Why must leadership be monopolised by the same group benefiting from the current setup?”
Isn’t it meant to undermine the current GP model?