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APMS contract retendered following concerns about overuse of non-GP staff

APMS contract retendered following concerns  about overuse of non-GP staff

An ICB has decided to re-tender an APMS contract currently run by Operose Health, following concerns around overuse of non-GP staff.

North Central London ICB will not renew the contract for Hanley Primary Care Centre in Finsbury Park, a practice caring for 10,700 patients currently run by AT Medics, after it was told of an under-provision of 270 GP appointments per week.

AT Medics was acquired in 2021 by Operose Health, which is a subsidiary of US healthcare giant Centene. 

The ICB told Pulse that the decision to procure a new contract was taken by the Primary Care Committee and ‘informed by a contract performance and quality review’ and ‘engagement with registered patients and local stakeholders’.

A report shared ahead of the committee meeting said that ‘there was an over-provision of nursing appointments’ at the practice.

It said: ‘Workforce data submitted covering core primary care staff showed an under-provision of 2.8 WTE GP and an under-provision of 270 GP appointments per week.

‘This is deemed significant to access for the registered patient list. There was an over-provision of nursing appointments.’

The report also said that the practice’s workforce data for core primary care staff ‘was a concern’ and there was ‘a large deficit of GP capacity’.  

It added: ‘PCCC members are reminded that APMS practices are reimbursed an additional £20 per weighted patient, above the global sum which gives providers financial levers to support recruitment and retention of staff in line with patients needs and the list size growth.

‘Pressures on recruitment are noted, but evidence will be required from the practice to show immediate recruitment action (locum or permanent) to reduce this gap.’

A notice published last week confirmed the ICB is retendering for the contract, which has an estimated value of £1,227,794 annually and will commence next summer.

The ICB meeting papers said the decision was recommended on the grounds ‘of limited evidence of improvement in screening and immunisation’ from the practice.

‘There was improvement in three out of 10 indicators, but only one indicator (bowel screening) was near the national target (3% below). There were no other indicators that were comparable to national targets.’

A spokesperson for Operose Health told Pulse: ‘We know how important it is for our patients to be seen as quickly as possible. That’s why we have continued to invest in more clinical and reception staff at the practice to improve patient access.

‘We are grateful for the team at Hanley for their unwavering commitment to patient care, despite all the uncertainty around the future of the contract over the last 12 months.’

Healthwatch chief executive Emma Whitby said: ‘The ICB have made a difficult decision, but their process was robust. They considered a great deal of evidence collected over the last six years.

‘This included feedback from patients as well as statistical data related to disease prevalence – this can help commissioners to assess whether the people in the community who most need help are receiving the expected levels of support from their GP. It is vital that Islington residents have good access to GP appointments.’

A BBC Panorama report last year had raised concerns over Operose’s use of non-GP staff within the practices it runs.

Centene’s entry into UK general practice two years ago faced legal challenges by campaigners trying to tackle NHS privatisation, who argued that patients were not adequately consulted on the takeover. 

Earlier this year, Centene was looking to sell its nearly 60 NHS GP practices, as part of a move to exit the UK health market, according to reports.

Operose now serves over 640,000 UK patients in surgeries and digitally, making it the largest primary care organisation in the country.


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Please note, only GPs are permitted to add comments to articles

Oliver Barnsley 3 October, 2023 1:06 pm

So a private provider getting extra per head funding (due to APMS) was recruiting cheaper staff instead of GPs so they could skim more money from the contract at the expense of patient care – not at all surprising.
What I am surprised by is that anyone still cared enough to step in and intervene about it…. I presume that is thanks to Panorama.

Nick Mann 3 October, 2023 1:39 pm

Campaigners presented BBC Panorama with some of the dirty dealings that got Centene the contract in the first place, together with their extensive record of fraud in US and Spain. It’s interesting how, when you choose to barely skim the surface of the operations of companies like Babylon and Centene (I think that’s usually called due diligence), one wonders how and why they were catapulted into the NHS in the first place. In both cases, had it not been for NHS campaigners, the dangerous Chatbot and the dangerous GP operational model would now be established as the ‘new models of care’.
Be worried. No-one in DHSC/NHSE is protecting patients.