Franchising 'a concept from the fast-food world'

The corporate franchise, such as the Heart of Birmingham scheme, will provide an 'over-arching framework' that offers a consistent range of services and quality from new, larger health centres.

The franchise is an agreement or licence which gives the franchisee (GPs or private companies) the rights to market a product or service (general practice) using the trademark of another business (the franchiser or the PCT).

It is a familiar concept in the fast-food industry, which Heart of Birmingham chief executive Dr Sandy Bradbrook admitted is 'an unfortunate connection'.

Developed alongside the national drive to move service from secondary care into general practice, and Heart of Birmingham's modernisation plan, the concept sees the patient as a consumer, and hopes NHS 'branding' will create a perception of consistent quality.

While moving most of the area's GPs into 24 new health centres, the PCT has the ability to tender the franchises to private companies where it believes the current provision is inadequate or below acceptable quality.

Although a PCT spokesman insisted that GPs would keep their current contracts, the report makes recommendations for providers on how to secure a franchise as the definition of GP preferred provider is 'developed over time'.

One of these methods is for GPs to group together to form limited companies.

Another suggests setting up a 'social enterprise' organisation, a company with a corporate structure with a public service aim.

GPs could join forces with a firm they wish to sell the business on to. GPs currently performing well could retain their contract but must 'focus increasingly on their business and service models' to maintain their long-term franchise contract, the report says.

Dr Charles Zuckerman, medical secretary of Birmingham LMC, said the long-term franchises would be APMS contracts with annual reviews.

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