LMCs warn over bid to force corporate integration of GP practices

LMCs have hit out at legislative proposals they fear could see GP practices forced to integrate into 'corporate entities' while core GP funding is stripped from the profession.

A motion set for debate at the UK LMCs conference on 11 and 12 May notes 'legislative proposals in some of our home nations which seek to reform the provision of core GP contracts, including where they are held and how they are funded'.

LMC leaders will call on the BMA GP committee to ensure GP contracts in each UK nation continue to be nationally negotiated, with funding ring-fenced to prevent it being diverted to secondary care or to cover trust overspends.

They will also demand a guarantee that 'the GP practice remains the unit at which core contracts are negotiated, ensuring practices are not forced to integrate into corporate entities with other practices or organisations without their specific agreement and consent'.

Integrated care

The BMA has previously warned that plans for 'integrated care provider' contracts risk undermining the existing GP contract, by shifting the NHS to a model in which all healthcare provision for an area comes under a single contract - with individual practices agreeing to suspend or give up their existing GMS, PMS or APMS deal.

The association has also warned that bringing healthcare provision together under integrated contracts increases the risk of privatisation at scale across large areas.

The debate comes as the government presses ahead with legislation for England that will see CCGs scrapped as around 40 integrated care systems (ICS) across the country take on budgets and commissioning powers.

A white paper setting out the reforms earlier this year said 'while NHS provider organisations will retain their current structures and governance, they will be expected to work in close partnership with other providers and with commissioners or budget holders to improve outcomes and value'.

Primary care networks

However, GPonline reported earlier this week that practices in an ICS covering part of north London were under pressure to change their primary care network into a 'legal entity' so that it could take over contracts currently held by individual practices or GP federations.

Meanwhile, another debate tabled for the LMCs conference will see GPs call for research to investigate 'the benefits/risks options and costs associated with the provision of UK general practice outside of the GMS/PMS/APMS contract model'.

The debate will call for guidance to be developed on how GPs currently operating as independent contractors could become 'employed GPs' - with modelling to look at how an employment model similar to the system for hospital doctors could work for general practice.

The conference will also hear debates on the workforce crisis facing general practice - just days after official figures showed a huge surge in GP appointments in the past month - and after NHS England acknowledged intense pressure on practices delivering heavy workload on top of participation in the COVID-19 vaccination campaign.

The conference will also debate calls for further work by the BMA to combat sexism and discrimination, just over two years after GPonline reported on senior GPs speaking out about a sexist culture within the BMA, triggering the Romney review.

It will also hear discussions about green general practice, pay and other issues. Click here to read the conference agenda in full.

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