Exclusive GP partnerships in London are likely to be history within 10 years, former RCGP chair Professor Clare Gerada has told Pulse, as they offer no ‘autonomy’ and are a ‘millstone around our necks’.
In an exclusive interview with Pulse, Professor Gerada – who is now an advisor with NHS England (London) – questioned whether the independent contractor status gives any benefits to GPs, claiming that because of today’s workforce demands on the profession, it’s time to ‘look at alternative models’.
She added that she does not believe that all GPs in London will be salaried in 10 years’ time, but there will be different models of care, and she said the independent contractor model would continue to exist outside London.
Pulse was speaking to Professor Gerada following the publication last month of NHS England (London)’s ‘transformation framework’ – led by Professor Gerada – which outlined plans for practices to merge or federate to offer routine opening on Saturdays and offer flexible appointment lengths as part an £810m a year bid to reshape general practice in the capital.
Her comments come as NHS Hull CCG revealed last month that it is in talks with GPs about a projected move to a completely salary-based model of primary care, in a bid to tackle major recruitment problems in the area.
Professor Gerada’s thoughts also echo comments made by shadow health secretary Andy Burnham, who previously told Pulse that the profession ‘should move towards becoming predominantly salaried,’ while NHS England deputy medical director Dr Mike Bewick said earlier in the year that GP partnerships will be ‘gone within ten years.’
At the RCGP conference last year, while still college chair, Professor Gerada called for GPs to give up their independent status and become salaried employees, saying that the independent contractor model was ‘anachronistic’.
But, speaking to Pulse this month, she went further, arguing that the GP partnership model would be an anachronism in the capital within a decade.
Professor Gerada told Pulse: ‘I don’t think everyone will be salaried. I think there will be different models. I think we’ve already seen it in London. If you say will there be independent contractors in London in 10 years’ time, I suspect not.
‘But if you ask whether independent contractor status will remain in some areas of Britain – yes of course it will. I would question whether the independent contractor status is beneficial to GPs. With today’s workforce, today’s demands on general practice, with the media seeing us as fat cats going off to play golf every afternoon because we are independent, I think this is a millstone around our necks and the sooner we look at alternative models the better.’
Professor Gerada foresees GPs being independent contractors to primary care organisations, adding that ‘new models will emerge’.
She said: ‘But the partnership model has stood the test of time for 70 years and it will probably stay around in certain areas. We could even be independent contractors to a primary care organisation. I think models will emerge. I’m not saying one size fits all.’
She went on to add that these new models could include completely salaried structures.
‘Shareholder models are already emerging. Social enterprise models, or completely salaried models, even models of foundation trusts employing GPs. You need to work out want you want to deliver, make the system safe, not for profit, then GPs with the right resource will make anything work,’ she said.