The first confirmed details of the new multispecialty community provider (MCP) new care model contract announced by NHS England’s board on Thursday confirmed that practices will be able to retain their GMS contracts if they sign up to the new arrangements.
Under two alternative models being developed by NHS England, practices will either continue to operate under GMS alongside the new MCP contract, or will work under a fully integrated single MCP contract, but retain their GMS rights.
Officials said they expect to expand national NHS England support for MCPs from coverage of 8% of the country today to around a quarter in 2017/18.
General practice at scale
Applications for support for future MCPs and PACs will be sought this autumn.
The framework for the contract is expected to be published today with the full contract details following in September.
Under the plans, commissioners will not be required to competitively tender from multiple providers, officials also announced.
But GP leaders said they remained concerned about the risks to practices. GPC executive member Dr Brian Balmer said: ‘The BMA will be looking at these proposals in detail, but we remain concerned that there are number of risks to GP practices who might sign a local, time-limited contract.
‘We would prefer that NHSE moves ahead with an MCP that allows different forms of contractual arrangements, so that innovation and flexibility is encouraged, while retaining a registered list based service that has been one of the great strengths of general practice.’
50,000 patient populations
MCPs will plan, budget and provide primary, community and possibly some secondary care service for populations over 100,000 based on the GP registered list and built around integrated care hubs serving 30-50,000 people.
The new framework sets out three alternative voluntary MCP contract models: a virtual, alliance contract; a partially integrated contract, which sits alongside retained GMS contracts; and a fully integrated model, with a single whole population budget across all primary and community services.
The fully integrated contract will be a simpler hybrid of the standard NHS contract and a primary medical services contract, but will last for 10 or 15 years.
The contract will comprise a whole population budget for the range of services, a new performance element to replace QOF and CQUIN, and a gain/risk share of funding for meeting acute activity objectives.
MCP contracts will be held by a community interest or limited liability company, a partnership such as a GP federation, or a statutory NHS provider.
An NHS England board paper notes that the contract model ‘opens up the prospect of new options for how GPs and other clinicians could relate to the MCP, but will not compel an existing practice to leave the security of its GMS contract in perpetuity’.