NHS Commissioning Board rejects call for APMS contract reform

The NHS Commissioning Board (NHSCB) has ruled out an overhaul of APMS contracts after a London council said the deals allow primary care to become a 'commodity traded in the private market' and undermine continuity of care.

Patients: 4,700 were left to find a new practice after the Camden Road surgery closed
Patients: 4,700 were left to find a new practice after the Camden Road surgery closed

A report in June by Camden Council into the closure of a north London APMS practice whose 4,700 patients were forced to move elsewhere warned that APMS contracts contained a 'serious loophole' that had allowed one private provider to transfer the contract to another.

A second Camden council report into the practice's closure will be discussed at the local authority’s health scrutiny meeting tonight.

Councillors will discuss lessons that can be learned from the closure in April of the Camden Road surgery.

One of the report’s findings is that existing procurement procedures ‘give insufficient weight to the need to develop sustainable GP care’ and that there are ‘insufficient safeguards to prevent avoidable use of locum and temporary staff’.

But the NHSCB denies that there is a loophole in current contractual arrangements. A spokeswoman said: ‘Under APMS contractual arrangements, if a provider no longer wishes to provide services to patients they should discuss this with the commissioner in line with the terms of their contract: it is the responsibility of the commissioner to ensure provision of those services.

‘We do not believe there is a loophole in the APMS contractual arrangements and therefore have no plans to change the contractual arrangements for APMS contracts.’

In June Camden Council’s Health Scrutiny Panel of Enquiry report into the closure called upon the NHSCB to take ‘prompt action’ to prevent a repeat of the incident. The panel's report said: ‘In our view, primary care by GPs should not be a commodity traded in the private market.

The panel hit out at private companies involved in running the practice for failing to provide evidence to the enquiry, and called for greater transparency on deals with private firms involved in running NHS services.

Private healthcare firm UnitedHealth UK won a five-year contract to run the Camden Road surgery in 2008, but then transferred the contract to another provider, The Practice plc, in April 2011. A year later, the practice was shut down when its premises lease ran out.

A UnitedHealth UK spokeswoman said: ‘Improvements were made at all Camden practices during our time - QOF improved, new services introduced and opening hours extended. All our dealings with NHS Camden were transparent. The report largely investigated events which occurred after our work in the area.'

A spokeswoman from the Practice plc declined to comment.

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