GMS contracts could become time limited

GMS contracts could become time limited and practices could be incentivised to integrate with large providers to cut NHS costs, influential policy experts say.

Dr Vautrey said vertical integration of primary and secondary care would be something the GPC would ‘oppose strongly'
Dr Vautrey said vertical integration of primary and secondary care would be something the GPC would ‘oppose strongly'

A joint report by the King's Fund and the Nuffield Trust, co-authored by Nick Goodwin, who is leading a review of general practice, suggests GMS is a significant barrier to the integrated care organisations (ICOs) mooted in Lord Darzi's NHS Next Stage Review.

The report suggests a time limit on the GMS deal would give PCTs ‘greater discretion' to ensure that practices cooperate with integrated services.

The proposals ratchet up pressure on the GMS contract in the week after an NHS Confederation report also called for the deal to be overhauled.

The confederation, which represents NHS managers, called for the MPIG to be scrapped, strengthened contractual levers to deal with poor or unresponsive services and a combination of incentives for practices to work federally and rewards for ‘increased scale'.

It also called for greater flexibility to negotiate GP contracts and for a national menu of QOF indicators that could be adapted locally.

The King's Fund/Nuffield Trust report makes clear that even if plans to impose time limits on contracts were ‘forcefully opposed by medical unions', an alternative would be to phase the deals out gradually by ensuring growth and incentives are geared towards integration with ICO-style groups.

‘Without powers to direct the transfer of existing GP contracts to ICOs...they may remain simply a minority sport for enthusiasts,' the report says.

Deputy GPC chairman Dr Richard Vautrey called the idea ‘nonsense', and said vertical integration of primary and secondary care would be something the GPC would ‘oppose strongly'.  

The proposals to reform the GMS contract comes after revised PMS regulations implemented this month made clear that a PMS contract can be revoked by a PCT, as long as six months notice is given.

National Association of Primary Care chairman Dr Johnny Marshall, said he would be ‘livid' if this means that a contract can be terminated without grounds.

A DoH spokesman said: ‘The amended PMS regulations simply clarify the existing provisions put in place in 1997 when PMS was first made available.'

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