Providers could be freely allowed to set up new GP practices, Monitor suggests

Any healthcare provider registered with the CQC could be freely allowed to set up new GP services to tackle rising demand, the government health regulator Monitor has suggested.

GP practice: should providers be 'freely allowed' to set up services?
GP practice: should providers be 'freely allowed' to set up services?

In a report on patient choice in GP services the competition watchdog called for commissioners and providers to do more to improve patient choice and empower patients to make better use of their right to choose.

The report found that relatively few new GP contracts had been awarded in recent years despite growing demand. The commissioning of new contracts was partly inhibited by funding constraints, the report said.

But it added that a system whereby ‘any provider that can provide adequate care, and holds CQC registration, is able to set up GP services’ could help meet patient needs, particularly in under-doctored areas.

The way GP services are commissioned is changing and this represents a real opportunity to improve things for patients.'

Catherine Davies, executive director of co-operation and competition, Monitor

Some provider organisations told Monitor’s inquiry that they would be ‘likely to start providing GP services if they could enter into new areas freely where and when they identify patient need, subject to meeting requirements including CQC registration’.

Monitor acknowledged concerns from NHS England that such a system risked ‘destabilising existing providers’ and would not reduce fixed infrastructure reimbursements such as premises costs. 

NHS England, however, agreed that such a move could result in more new GP services in non-traditional locations, and increase competitive pressure on existing providers to improve services.

GPC chairman Dr Chaand Nagpaul warned that allowing new practices to 'pop up' and compete for patients could destabilise exising GP services, and would 'fly in the face' of NHS England's plans for practices to work increasingly in collaboration with other NHS services.

Commercial GP services

'It is vital GP services are planned in a co-ordinated manner,' he told GPonline. 'It doesn’t make sense to create a wildcard arrangement where practices are set up in completely commercial sense.

'Clearly there is a need to address underdoctored areas and increase capacity where there are currently insufficient GP services. But having standalone, piecemeal arrangements is not a sensible way to address these problems. It would be pointless to allow new services if they destabilise existing ones.'

Monitor also suggested that providers having the ability to provide information about their services to patients ‘is likely to benefit patients by improving their ability to choose the provider that best meets their needs’.

The report found that resource constraints, increased demand and the workforce crisis were restricting GPs’ ability to respond to patient needs.

Changing GP services

Monitor’s executive director of co-operation and competition Catherine Davies said: ‘The way GP services are commissioned is changing and this represents a real opportunity to improve things for patients.

‘Commissioners have the chance to help the NHS meet the needs of a growing and ageing population by improving access and capacity of GP services in England.

‘Patients can also play a part by exercising their right to choose which surgery they go to and, if required, changing practice to one that better meets their needs.’

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