All 90 practices in the city, through their federation, are seeking partners for a joint bid for the ten-year contract to provide a range of community, primary and social care services, according to local GP leaders.
A tender notice for the new local care organisation (LCO) was published by NHS Shared Business Services on behalf of Manchester Health and Care Commissioning, which brings together the CCG and council.
The LCO is expected to be contracted on a MCP-model to provide integrated at-scale services through practices. All 90 practices in the city have now agreed in principle to sign up to a partially-integrated MCP-model under which they will keep hold of their existing GMS or PMS contracts.
Manchester LMC chief executive Dr Tracey Vell said is was not clear at this stage whether the new LCO would be a provider alliance or a more formal arrangement, but agreement had been reached in initial discussions that practices would not enter any formal joint venture without an equal share in the ownership with the other providers.
The LCO is likely to end up holding other contracts as well as the MCP, to provide a wider range of out-of-hospital services, according to Dr Vell.
The tender notice said the provider would operate through a ‘neighbourhood model’ with an emphasis on population health and prevention, building on self-management, targeted care support and complex care.
‘To do this they will need to deliver sustainable, high quality, safe and affordable prevention, primary, community, secondary health & social care services, through a blend of direct and subcontracted provision’, it says. Over time, the tender notice added, some hospital services could be transferred to the new LCO.
Dr Vell said once the contract is awarded to the new provider, discussions will take place around the exact form of the MCP contract. However, all practices have agreed that at this stage they want to enter a partially-integrated model, maintaining their existing contracts in full.
‘The GPs have already said in the 90 surgeries in the city of Manchester that they would be happy to partially integrate to put the MCP contract over their enhanced services in an integration agreement,' she said.
‘The practices have made written statements that the GP federation will negotiate on their behalf. They have agreed to the federation being an equal shareholder,' Dr Vell added.
Once the tender is awarded, she said, the federation will go back to the practices with the integration agreement to seek further clarity.
‘The organisational form of the LCO may shape some of the other decisions. So in taking that forward, it will then have to be the GPs in their practices that decide what the options are, depending on that form,' she said.
The practice federation, would be part of a ‘combined bid’ said Dr Vell, but that ‘doesn't tie them in, it's just a signed agreement to progress’.
‘The MCP cannot take place unless general practice is within in it, so by default they choose the partner, and so depending on who approaches general practices, it would be up to them to partner with.’
The Primary Care Manchester practice federation said it was involved in negotiations and unable to comment. Manchester Primary Care Partnership did not responsd to a request for comment.