Exclusive: GPs could ditch practice contracts to work in chambers, says senior GPC member

GPs should consider handing back practice contracts en masse and working for the NHS through chambers to manage workload, a senior GPC member has suggested.

Dr Zoe Norris, who took over as chair of the GPC sessional committee in July, told GPonline that if all GPs delivered their services to the NHS through chambers the profession could have more leverage to refuse unsafe workload and avoid burnout, but retain a form of independent contractor status.

More than a dozen GP chambers - groups set up by locum GPs that offer business, professional and governance support to their members - already operate across England, mostly on a small scale.

The proposal for a wider adoption of the chambers model comes as the GPC prepares to decide later this month whether to ballot the profession on its willingness to resign en masse or take industrial action over the GP crisis and dissatisfaction with solutions offered in the GP Forward View.

GP contract action

The National Association of Sessional GPs (NASGP) urged the GPC to draw up serious proposals for a widespread shift to chambers ahead of the ballot, to provide a 'Plan B' if GPs vote in favour of mass resignation.

Dr Norris, a locum herself, said that working through her local chambers – the Yorkshire Medical Chambers – had ‘saved her career’.

‘I think the chambers model is great – it works as a virtual practice to provide GPs with CPD, peer support, help with appraisal and revalidation, and a whole range of resources - not least all the paperwork we need to do,’ she said.

‘Joining chambers saved my career. I would have left medicine. There is strength in numbers and I've pointed to the chambers model before as an example of alternative independent contractor status.

‘If all the GPs in an area handed back their contracts and formed a chambers, they can contract services back to providers in a way that is far safer and more sustainable that what many of us are currently doing.

GP workload

‘It feels like no one is bothered about the impact on patient safety and burnout of the current workload in general practice. Perhaps we need to take the initiative as a profession before we have no choice?’

Dr Richard Fieldhouse, chairman of the NASGP, agreed with the proposals, but warned that this would be the ‘nuclear option’, as locum chambers have always supported partner and salaried GPs – and not acted as the sole model for general practice.

However, he stressed that it was one the GPC should be prepared to take. ‘Since I set up the first GP chambers in 2004, I’ve said that the future of general practice will consist of a symbiotic relationship between groups/federations of GP practices and local locum GP chambers,’ he said.

‘If I were in Zoe’s position – and I’m glad I’m not – my one thing to achieve over the three-year term would be to drag the GPC into a position where it seriously develops the entire all-GPs-resign-and-become-chambers-locums to its logical conclusion, so that when they do make their "let’s resign" threat, they really do have this as their Plan A, let alone a Plan B.’

A GPC spokesman said the committee's position was that locum chambers were a helpful way of working for many locum GPs, but that the arrangement would not suit all locum GPs.

Read more: Dr Norris on her priorities as GPC sessional chair

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