DoH steps up private provision...

The DoH is escalating its APMS programme with around 30 contracts set to be put out to tender this year.

The Fairness in Primary Care Procurement programme will be rolled out in three waves, the first by the end of this month and covering four areas, a second by the end of May and a third by the end of the year (see graph).

England’s most under-doctored areas will be targeted, with the aim of including all 30 areas listed in last year’s primary care White Paper as having the lowest level of GPs per 100,000 population.

A DoH spokesman said that only PCTs that were financially ‘ready’ would be able to implement the contracts, which were to be funded locally.

A number of private providers have shown an interest in the contracts, although those without direct healthcare experience will be expected to bid in partnership with GPs or private medical firms.

This expansion of the APMS initiative follows a pilot launched last year with mixed success in Plymouth, Liverpool, Lancashire, Yorkshire and London.

While two contracts in London were successfully put out to tender, with City and Hackney, and Barking and Dagenham PCTs commissioning Mercury Health and Care UK respectively to run GP services, the Plymouth contract was abandoned and the remaining three ‘are still in talks about the contracts’, according to the DoH spokesman.

The expansion is part of a wider policy drive announced by the prime minister’s delivery unit this week to increase choice and tackle social exclusion.

Health secretary Patricia Hewitt said that ‘thousands of NHS patients’ were set to benefit from this expansion in APMS contracts, particularly because many contracts would have a focus on extended opening hours.

However many GPs are not so enthusiastic. Dr Greg Place, LMC chairman in Nottinghamshire, which is part of the first wave of contracts along with Hartlepool, County Durham and Great Yarmouth, said: ‘We agree there needs to be something done about increasing capacity, but why not do that by helping existing provision? What we called for was new GMS premises, but the PCT wasn’t interested.’

He also believed there would be little interest from GPs in handling the contract, because the plans were for early-morning, early-evening and Saturday-morning openings. He added that patients might also not be interested — his surgery had to end its Saturday-morning sessions because of the lack of interest.

Dr Richard Fieldhouse, chief executive of the National Association of Sessional GPs was also sceptical.

‘This will involve no continuity of care, no superannuation and, I think, tick-box doctoring that will not appeal to many GPs,’ he said.

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