Right to return clause for GPs adopting new models of care deleted in error, says NHS England

A clause confirming GP practices' right to return to their previous contracts if integration under new care models fails was omitted from updated guidance by mistake, according to NHS England.

GP contract: right to return clause omitted by mistake
GP contract: right to return clause omitted by mistake

The removal of an apparent commitment to allow practices ‘rights of return’ appeared to confirm GP leaders’ fears over new models of care, but NHS England has told GPonline the omission was an error.

Just last week the GPC warned practices that signing up to new multispecialty community provider (MCP) contracts that bring multiple practices together under a single deal could be a ‘one-way street’.

GPC deputy chairman Dr Richard Vautrey said practices that sign up for population-based MCP contracts to deliver primary care at scale may find the deals are irreversible.

GP contract

Dr Vautrey’s comments came as GPs in Manchester agreed to become the first to agree a new local MCP contract. A deal being developed with the city's LMC could see practices form a single legal entity comprising multiple existing providers to deliver care for populations of 30,000 to 50,000 patients.

In October the government announced that a new voluntary contract would be launched in April 2017 to support the MCP new care model vanguards.

The new deal would see groups of practices providing seven-day services in return for dumping some of the bureaucracy of the QOF.

Dr Vautrey warned practices of ‘huge risks’ in walking away from their GMS or PMS contracts to sign up for an overarching MCP deal. Such a move was likely to be a ‘one-way street’ – regardless of whether promises for a right to return were made, he said.

NHS models of care

In a document outlining NHS England’s national support package published in July, vanguards were told that new capitated contracts for MCPs would include options to attract practices away from their existing funding arrangement ‘including ways to enable "rights of return"’.

But in an updated version of the document published on Thursday, all references to that those rights had been removed. 

Similarly in a section of the document setting out design principles a line which read: ‘standard MCP contract perhaps with modular elements; new organisational forms; or "rights of return" for GP practices’, was changed to remove any mention of the right to return.

A spokesman for NHS England told GPonline that the omission was an error that would be corrected.

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