The first major document published as part of the review into the future of the GP partnership model sets out 23 key questions for general practice, covering workforce, workload, the business model of general practice and the role of general practice in the local healthcare system.
The 'call for evidence' document asks whether GPs should be able to hold GMS or PMS contracts through 'limited liability partnerships' to reduce the personal financial risk they take on when they become partners. It asks how greater working at scale in general practice can be encouraged and incentivised - along with greater collaboration between GPs and other NHS services.
In a foreword to the 'call for evidence' document, review chair Dr Nigel Watson says the review will examine the challenges facing the partnership model and consider how best to reinvigorate and equip it to help lead the transformation of general practice for the future'.
GP partnership model
Echoing those comments in the call for evidence, he wrote: 'I strongly believe that the partnership model of general practice has not reached the end of the road. It predates the NHS and has evolved to support changing population needs, and will do so in the future.
'However, it is important to recognise that this model is not the only way to deliver care. We are learning from new models of care, and federations, super partnerships and other models all have a place in primary care.'
The call for evidence document says that GP partnerships provide 'exceptional value for money', costing less than £3 per patient per week for unlimited access to a family doctor.
Dr Watson has begun a series of visits to look at different GP models across England, visiting Birmingham, Devon and Hull in recent weeks - and the review asks what general practice can learn from good local examples of care.
The New Forest GP argues that the independent contractor status of general practice is the 'foundation of the core strengths' of the profession. But he warns that whereas in the past buying into a partnership was seen as a good investment 'this is no longer always the case'.
He says: 'This business model comes with its risks as well as rewards; for example, the burden of holding a large mortgage, employing large numbers of staff and personal financial risk and liability. I am concerned that, for those considering becoming partners either now or in the future years of their career, the risk outweighs the rewards of the job.'
The call for evidence document asks about the role of technology, how solutions to attract GPs to partnerships may differ for people at different stages of their career, how partnership models can address workload and ease the burden of risk for partners.
It highlights 'unmanageable' workload in primary care and asks for examples of systems to address it.
The review asks how attractive features of locum and salaried working could be introduced to partnership roles, considers career progression in general practice, and how variation in pay between partnership and non-partnership roles affects doctors' career choices.
GPs have been urged to read the call for evidence and get in touch with the review team at GPPartnershipReview@dh.gsi.gov.uk