General practice could be 'outsourced' to private corporations under MCP deal, warns BMA

General practice could be outsourced to private corporations under multispecialty community provider (MCP) contracts set to be rolled out this year, GP leaders have warned.

The GPC said that tendering requirements for the new MCP contracts, the first of which are expected to be adopted in shadow form in April, could see GP services outsourced to private companies.

Current procurement laws require health service contracts worth more than €750,000 to be advertised, so MCPs are are likely to have to go through an open procurement process, the GPC believes.

Dudley CCG became the first to begin a procurement process for an MCP last month. The CCG expects a single organisation to run the MCP, delivering services including community-based physical health for adults and children, some outpatient services, primary medical services including GMS, PMS and APMS, local enhanced services, all mental health services, public health, learning disabilities services, urgent care centres and GP out-of-hours care, while adult social care services will be phased in.

GP contracts

Guidance on MCP contracts published this week by the GPC said that while NHS England had put in place measures to require prospective bidders to have the support of local GPs, ‘NHS England acknowledges that "this does not mean that GPs have preferred provider status for the MCP contract".’

NHS leaders have said, however, that under no outcome would GPs ‘lose their right to continue to provide primary medical services against their will’.

But GP leaders warned that the procurement process ‘raises the very real prospect of general practice being outsourced to private corporate entities via MCPs, with no guarantee that such an open procurement process will result in local GP-led organisations winning the resultant contract’.

‘This has already been the case for a number of large NHS community contractors who are now managed by commercial companies and it is reasonable to assume that this could also be the ultimate outcome for MCPs,’ the GPC guidance says.

‘In such a situation local practices would potentially find themselves set in competition for patients against the emerging MCP body commissioned by NHS England to provide a much wider service than available through traditional general practice.’

GPC executive member Dr Gavin Ralston said: 'For some GPs being part of a fully integrated MCP may seem attractive given the current pressures on general practice. However there are clear risks with giving up a national contract for this option, as there will be limited opportunities for GP practices to return to the exact contract arrangements they were previously on.

'Patients may also lose some of the continuity of care that they value as part of their relationship with their local GP practice. The new MCP contract is also time limited and will be subject to further procurement processes in the future. This will mean that constituent practices may have to compete against commercial companies to retain the contract with, as we know, absolutely no guarantee of success.

'The key benefit GPs must look for when considering the MCP contract is whether it reduces bureaucracy and workload. Whatever model GPs choose, the current crisis in general practice will not be addressed by contract changes. Instead a systematic programme of investment in general practice by government is needed.'

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