Q&A: NHS chief executive Simon Stevens on contractor status, MPIG and salaried GPs

In an exclusive interview with GPonline, NHS England chief executive Simon Stevens set out his stance on key issues for GPs - independent contractor status, salaried GPs, care models and MPIG.

Simon Stevens: independent contractor status has a future (Photo: Alex Deverill)
Simon Stevens: independent contractor status has a future (Photo: Alex Deverill)

GPonline: 'Will most GPs still be independent contractors in five years’ time?'

Simon Stevens: 'Probably, but that is a matter for individual GPs. I'm clear that there is value in having a national contract and an independent contractual option, but one of the great strengths of general practice in this country has been its adaptability. It doesn't look the same everywhere, and individual practices get to make decisions about how they want their services to evolve. So I expect, yes, there will continue to be an independent national contract and a large number of GPs may well still be on it.'

GPonline: 'Do new models of care mean more salaried GPs?'

Simon Stevens: 'That will be, ultimately, a judgment for practices themselves. I'm sure it will evolve in different ways in different parts of the country, but I doubt we will end up - and I don't think we should end up - with a single model for what practice looks like.'

GPonline: 'Will the GP funding formula be reformed?'

Simon Stevens: 'We have made this suggestion to the BMA that we are willing to take a fresh look at the way in which the funding formula for primary care works. And I think we are willing to do that on whatever timetable the GPC thinks makes sense. By definition, the only point of doing such a review is if people think that right now the formula is not sensitive enough to the kinds of factors that should be taken into account.

'That means that if you have a new formula, there will be relative winners and losers, and so, you've got the same issue to deal with. So, nothing in this life is completely straightforward, but if the question is, are we willing to look at the funding formula to ensure it deals with the issues people think are wrong with Carr-Hill, the answer is yes. Timetable to be agreed with the GPC.'

GPonline: 'Will there be an expanded financial support package for MPIG losers?'

Simon Stevens: 'The issue is that this is zero-sum. So, anything that is about how do you divvy the pot up, if you give more to one set of practices, you are giving less to another. This is part of the reason why I've been so keen on giving GPs locally the ability, if they want it, to make these decisions themselves collectively through CCG co-commissioning. They will therefore have the ability to make these sensitive judgments locally, which is much harder to do on some kind of vanilla national formula.'

Read more: Simon Stevens interview in full

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