Tower Hamlets CCG has agreed a proposal to contract £5m of local enhanced services with the GP Care Group, a federation comprising all 37 practices in the borough.
Practices in the borough have for several years collaborated on local enhanced services, with work contracted and provided through eight networks of four or five practices. The model has recently informed national policy-makers' plans to encourage more at-scale working.
The new arrangement will see the federation contracted by the CCG, reducing transactional burdens on both practice networks and commissioners, and streamlining the process.
Practices will see no change in the funding they receive, but payments will move from quarterly to monthly. Federation bosses believe the new arrangement will reduce the burden on practices to reconcile information and to arrange payments, reducing the chance of payment irregularities.
GP Care Group chief executive Chris Banks told GPonline that practices were already contracted through their networks to provide a range of local services including integrated care, child immunisations, health checks and diabetes services, with 'each network looking at the management of its own incentive scheme and submitting and monitoring returns'.
Commissioners wanted to contract with the federation to 'simplify some of the processes and achieve the same ends'.
'It's really a consolidation of what was already there and trying to streamline it into one organisation,' said Mr Banks.
In future, the contract will be held by the federation, while practices will continue to provide the services through the networks.
Accountable care system
'It's potentially a move towards an accountable care system,' added Mr Banks, 'with providers taking on more of the management of the contract.'
Targets and KPIs will continue to be reviewed regularly by negotiation between the LMC and CCG, while the cash flow will be managed by the federation with no change to the total overall funding. Performance indicators will be reviewed quarterly with an annual reconciliation for adjustments.
From an individual practice perspective, the changes shouldn't make much difference, said Mr Banks, other than the move to monthly payments which should help practices.
Potential streamlining will come from consolidation of management work, such as data collection and cash flow, currently carried out at network level, releasing resources back into the system.
While responsibility for staffing services will continue to lie with practices, the CCG has said the new arrangement will enable 'practices to share workforce '.
The CCG has also said the plan will allow for a more population-health approach to providing services.