GP-led firms are the big APMS winners

Posted on April 17, 2009. Filed under: GP-led health centres, News stories | Tags: , , , , , , , |

Pulse | By Gareth Iacobucci | 18 November 2008

Companies led by GPs are the big winners in the Government’s rollout of APMS services and are dominating the bidding for services across the country, a new analysis reveals.

But a new breed of business-minded GPs are blurring the boundaries between general practice and the private sector and in some cases pitting GP against GP.

One GP-led company has now secured a contract to run services hundreds of miles from the practice at which it is based, yet local GPs are often struggling to win bids.

Academics from the Health Services Management Centre, based at the University of Birmingham, found that since 2004 113 tenders had been won by new market entrants, including a long list of new born GP companies.

GP-led firms have won ‘significantly more practices than either corporate providers or social enterprises’, it adds.

Well known companies such as United Health, Atos and Care UK make up just 9% of the total figure, with GP-led companies gaining 89% of contracts, and not for profit social enterprises the remaining 2%.

But the researchers admitted it was now increasingly difficult to distinguish between GPs and private providers.

Professor Chris Ham, professor of Health Policy and Management at the University Of Birmingham, who led the research, said ‘Quite a lot of the GP bidders have turned themselves into separate companies to bid for contracts, and quite a lot of the corporate bidders have strong GP involvement. The categories we’ve been using in the past are increasingly unhelpful.’

The rise of APMS has had another controversial twist, pitching local GPs against bidders often from far afield. Pulse revealed in September that many local GPs had failed to make it past even the initial stages of bidding for Darzi centres.

Professor Ham said the research had revealed widespread concern about the quality of local bids, which had been embarrassed by more professional bids by GPs turned entrepreneurs.

‘This had created a tension between needing to ensure the conditions for open and fair competition, but wanting to support and encourage local practices to bid.’

Local GPs have often found themselves outgunned. Last week, Kent-based GP group Malling Health was announced as preferred provider for a new Darzi practice in Weston-Super-Mare, North Somerset, nearly 200 miles away.

Dr Peter Maksimczyk, a GP in Weston-super-Mare, who lost out to the Malling Health bid said: ‘I can’t see how GPs from Kent can pick up the difficulties. Practice is different in towns like Weston. It’s very difficult to see this as anything other than a complete slap in the face.’

But Dr Thomas Reichelm, development lead for Malling Health, said: ‘We’re aware there might be some initial rejection but we’re fairly confident that by meeting people in person, we’ll be able to convince them we have no bad intentions.

‘We’ve already started the process of finding out the local sensitivities and what matters locally. It’s quite refreshing to bring a new outlook and perspective.


GP-led companies
Companies set by GPs for the purpose of bidding for general practice and other primary care contracts. Have access to NHS pension scheme. Key players: Chilvers McCrea (37 practices), SSP Health (11 practices), Aston healthcare (9 practices), Intrahealth (8 practices)

Corporate providers
Investor owned companies, usually operating for profit. Do not have access to the NHS pension scheme. Key players: United Health UK (5 practices), Care UK, (3 practices), Atos healthcare (2 practices).

Social enterprises
Not for profit organisations – often set by groups of healthcare professionals, which reinvest any profits back into the organisation. NHS staff still transferring into new social enterprises and delivering NHS care can stay in the NHS pension scheme. Current players: Central Nottinghamshire Clinical Services, (Nottingham) Willow Bank (Stoke)

Source: Health Services Management Centre – Choice and Competition in Primary Care: Much ado about nothing?

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New primary care centre

Posted on April 6, 2009. Filed under: Press/News Releases, Providers | Tags: |

Nottinghamshire County tPCT | Press Release | 12 February 2008

Nottinghamshire County Teaching Primary Care Trust has awarded a contract to Central Nottinghamshire Clinical Services (CNCS), which will mean a new primary care centre in Kirkby-in-Ashfield.

After a formal tendering process as part of the Fairness in Primary Care procurement programme aimed at increasing the number of doctors in deprived areas which are seen as having lower levels of provision, CNCS has been signed up to run the new primary care centre at Ashfield Health Village in Kirkby-in-Ashfield.
CNCS is a social enterprise made up of local GPs and already provides out-of-hours GP services across the central Nottinghamshire area. CNCS was awarded the contract due to its high quality and innovative bid.

The service will be housed in a new primary care centre being developed at the former Byron ward at Ashfield Health Village. It will be known as the Kirkby Community Primary Care Centre. It will offer extended opening hours (8am – 8pm Monday to Fridays) and Saturday morning surgeries, to help ensure services are even more accessible and convenient for NHS patients. Patients will be able to access a range of primary health services which are aimed at making real health improvements for patients registered with the practice. For example enhanced services for patients with a learning disability; heart disease; weight management programmes; smoking cessation services. The primary care centre will also provide medical support to the new inpatient intermediate care services at Ashfield Health Village.

Patients will be able to register with the practice once it opens in late March.

Eleri de Gilbert, director of provider services and deputy chief executive of Nottinghamshire County PCT, said: “We are delighted to have secured a high quality provider for this new centre. I am confident that the people of Kirkby-in-Ashfield and district will welcome this new practice which will offer extended opening, new services and further choice for local people.”

Anita Dixon, Chief Executive for CNCS, said: “We look forward to working with Nottinghamshire County Teaching PCT to deliver enhanced General Practice services to the community of Kirkby-in-Ashfield and to build on our existing excellent record of delivering out-of-hours care locally. We aim to provide an innovative practice to improve the health of the local population. Our investment in a community engagement worker demonstrates our enthusiasm to further enhance our patient centred approach to care. The primary care centre will be an integral part of Ashfield Health Village with the majority of primary care services patients may need to access under one roof.”

The new primary care centre has been set up thanks to a £1.1m grant towards the capital works at Ashfield Health Village from the Department of Health’s community hospital fund. Ashfield is ranked third nationally for having low numbers of family doctors per head of the population. The CNCS contract is one of the first in the country to be signed under the Department of Health’s Fairness in Primary Care Procurement process designed to attract GPs to under-doctored areas.

Ben Bradshaw MP, Minister for Health Services, said:
“Access to GP services has been identified as one of the top priorities for the NHS. I welcome this announcement. I am particularly pleased that the new centre will be open early mornings, evenings and on Saturdays. The public tell us that they would like to be able to visit their GPs at times convenient to them and last year’s GP patient survey showed that nearly six and a half million patients were unhappy with the opening hours of their GP services.”

A special help line has been set up to give patients more information about registering with the new primary care centre. Call on 01159 34 32 62.


For more information please contact:
Joanna Kowalski, communications manager
Phone: 01623 414114 ext 4681

Notes to Editor
In January 2006, the White Paper, ‘Our Health, Our Care, Our Say’, committed to the Fairness in Primary Care procurements to address health inequalities in the most under-doctored and/or spearhead areas throughout England. Through providing additional primary medical care services in under-doctored and/or Spearhead areas, the Fairness in Primary Care procurements are expected to provide patients with greater access and choice, including flexible opening hours, extended services and easier access to high quality primary medical care services in their local area.

Nottinghamshire County Teaching Primary Care Trust (tPCT) is one of the four PCTs involved in Tranche One of the procurement, the other participating PCTs include County Durham PCT, Hartlepool PCT and Great Yarmouth & Waveney.

In October 2006 Nottinghamshire County Teaching Primary Care Trust (tPCT) took over the functions and responsibility from six former PCTs – Ashfield, Broxtowe and Hucknall, Gedling, Mansfield District, Newark and Sherwood and Rushcliffe PCTs.

The PCT plans and pays for the healthcare of 650,000 people in Nottinghamshire. In 2007/08 more than £770m was spent on buying care for the people of Nottinghamshire.

The PCT is responsible for all community NHS services, such as district and school nursing, health visiting, GPs, dentistry, opticians, and pharmacy and it employs more than 3,000 staff.

One of its key responsibilities is to improve and protect the health of the local population by tackling health inequalities, such as reducing smoking, which is the major cause of cancer.

It is also in charge of allocating money to local NHS trusts, such as Nottinghamshire Healthcare Trust, Nottingham University Hospitals NHS Trust and Sherwood Forest Hospitals NHS Foundation Trust, to buy services for patients living in Nottinghamshire County.

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