GPs must not be pressured to join integrated care contracts, warns BMA

The BMA has warned that GPs must not be pressured to abandon their current contracts, after the government changed legislation to allow practices to join area-wide integrated care provider (ICP) deals.

GPC chair Dr Richard Vautrey (Photo: BMA)
GPC chair Dr Richard Vautrey (Photo: BMA)

Changes to secondary legislation introduced by the government on Thursday mean that 'GPs who wish to integrate with an ICP can easily transfer their services from previous contracts to a new ICP contract if they choose to do so', a government statement said.

ICP contracts are described in the NHS long-term plan as allowing 'for the first time the contractual integration of primary medical services with other services, and creates greater flexibility to achieve full integration of care'.

The government statement is clear that GP practices will not be forced to switch contracts, but GP leaders fear they could come under pressure as integrated care arrangements take shape under the new five-year GP contract agreement and the NHS long-term plan.

GP contract

GPC chair Dr Richard Vautrey told GPonline: 'We have repeatedly expressed our serious concerns about ICP contracts which leads to practices giving up part or all of their GMS contract as a result. Practices should not feel pressured into entering an ICP contract as to do so could leave their patients worse off.'

Primary care networks (PCNs), which all GP practices are expected to join by June this year, are described in the five-year GP contract agreement as 'an essential building block of every integrated care system'.

Integrated care systems will be formed across England by April 2021, and are likely to be built around CCG areas, the NHS long-term plan suggests. These organisations will have the option to 'give one lead provider responsibility for the integration of services for a population' - and could seek to integrate services including primary care contractually through an ICP contract.

The government statement setting out changes to legislation confirms that ICP contracts are expected to be held by 'statutory providers, such as NHS foundation trusts'.

Hospital takeover

In parts of England, practices are already being run by hospitals - GPonline reported last year that a West Midlands trust had taken over 18 practices covering 100,000 patients, and that more than dozen other health economies were keen to 'replicate the model'.

Dr Vautrey added: 'The development of PCNs and our contract agreement is a far better way to deliver collaborative services that benefit patients within a community that is built on the foundation of the practice contract.'

Health minister Stephen Hammond said: 'As part of our long-term plan for the NHS we want to make sure care fits around patients and not the other way round. These new regulations are a crucial step towards more integrated care for patients in England.

'Integrated care providers will give local areas the power to integrate care by bringing all the different healthcare services provided to local residents into a single contract.'

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