Community nurse teams could compete with GPs

Community nursing teams could compete with practices for enhanced services following a change in the way they are funded, doctors have warned.

The DoH expects all in-house PCT providers to be in a contractual relationship with commissioners by April, with a view to becoming legally separated.

The standard community services contract will link community teams' funding to their quality of service. But this will incentivise them, rather than practices, to provide services such as flu vaccines.

'PCTs may start asking why they're paying that particular practice when so much of the work is being done by another provider,' said NHS Alliance vice chairman Dr Donal Hynes.

He urged practices to work with community services: 'If they don't, they may find some of their work disappearing.'

Services that community teams may be well placed to provide include children's health, immunisation and the management of long-term conditions.

Such moves are likely to be facilitated by the roll-out of the summary care record system, which would let other providers access GP patient records.

Dr David Jenner, the Alliance's GMS lead, said that ambitious former PCT provider arms could also bid to run GP services under APMS deals.

But he added that moves to divest PCTs of their provider arms could allow practices to bid to work with community nursing teams, or to provide such services themselves.

Ninety per cent of community service teams are funded through block contracts. But under the new contract, meeting quality targets will initially be worth 0.5 per cent of the contract's value.

The DoH has said that in the long term community services are a 'priority' for inclusion in Payment by Results.

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