National Association of Primary Care (NAPC) – GP contract crisis (UK)

Citation

(2010), "National Association of Primary Care (NAPC) – GP contract crisis (UK)", Leadership in Health Services, Vol. 23 No. 3. https://doi.org/10.1108/lhs.2010.21123cab.001

National Association of Primary Care (NAPC) – GP contract crisis (UK)

Article Type: News and views From: Leadership in Health Services, Volume 23, Issue 3

Edited by Jo Lamb-White

Keywords: General practitioners, Performance management, Leadership, Primary care

Recent amendments to the regulations covering Personal Medical Services (PMS) contracts may do little more than confirm the rights of Primary Care Trusts (PCTs) and general practices to withdraw from PMS contractual arrangements where appropriate. But inadequate actions being taken by some PCTs in relation to those contracts could lead to a catastrophe for the NHS, warns NAPC.

Dr Johnny Marshall, Chairman of NAPC, said: “While the Association would support the withdrawal of a PMS contract on reasonable grounds – underperformance, for instance – it is vehemently opposed to the unilateral withdrawal or undermining of the viability of a contract based on an arbitrary change of direction on the part of the PCT”.

“Many of our member practices” Dr Marshall commented “are expressing grave concerns about the stance being taken by some PCTs in ‘renegotiating’ their PMS contracts”. “PMS contracts should be viewed as a mechanism to drive up quality and productivity locally, while at the same time being required to deliver excellent value for money. While some PCTs have been engaged in mature on-going debate with their PMS practices, others have, more recently, taken a crude cost cutting approach, seeking to reduce PMS costs without any appreciation of the damage this is likely to inflict on local health services”.

Dr Marshall added, “any PCT which has failed to develop value for money services from its PMS practices to justify its costs and to demonstrate its contribution to the local health system is clearly not a world class commissioner”. “The simple reality is that PMS practices have been allocated resources to enable them to contribute to the local health care system in a way which non PMS practices may not resourced to do. It is self evident that PMS costs will be higher than those for non PMS practices’. “What matters is that PMS practices should be called to account for the improvements they are delivering. Any PCT which has failed to do so and which now seeks to remove or undermine PMS contracts is neglecting its duty to local people”. “The reality is”, said Dr Marshall “that PMS practices are unlikely to continue their innovative approaches to delivering and managing the use of healthcare services if their contracts are undermined by PCTs’.

Dr Charles Alessi, an NAPC executive member adds “PCTs need to consider what extra value PMS practices bring to the local health economy as a whole not assume a narrow view that primary care is all the same and thus should be resourced on that basis. It should be incumbent on a PMS practice to demonstrate benefit to a health economy by managing costs more efficiently across the whole of the health continuum, and to justify its extra value to reflect its extra resourcing. It is also wholly commendable for PCTs to be robust in their performance management. PMS practices have the potential to be developed into a benefit to the health economy not a drain, and help the NHS manage its resources more effectively. The challenge is for PCTs to assist in this pursuit if they really aspire to be world class commissioners”.

Dr Peter Smith, vice president of the NAPC said “Local Medical Committees (LMCs) and the General Practitioners Committee (GPC) have offered little or no constructive help to PMS members”.

Dr Smith went on to say “If a PCT is seeking to unilaterally bring about a change to a PMS contract and is threatening the withdrawal of that PMS contract without robust and reasonable grounds then NAPC believes that such action is wholly inappropriate and will seek to challenge it”.

NAPC is calling on the Department of Health to require PCTs to enter into meaningful dialogue with its local practices about any proposed changes to PMS contractual arrangements. The Association is considering further steps in support of member practices, which have experienced inadequate intervention by PCTs.

For more information: www.napc.co.uk