Sunday, November 7, 2010

NHS: Circle to Serco

It has already started!!!

08 April 2008
GPs are being offered a host of incentives to join up with private firms, with companies such as Chilvers McCrea Healthcare, US giant UnitedHealth and Atos Healthcare already employing salaried GPs at a growing number of APMS (alternative provider of medical services contract )practices across England.
Dr Julian Neal, a Circle GP partner and a member of the company’s primary care development team, says: ‘We’re about providing practices with the opportunity if they wish, to develop new services which are certainly not just PMS/GMS.’
The company is also planning to develop a network of polyclinics across the country, where consultants and GPs will work alongside each other.
Dr Neal, who is chair of the Portsmouth GP-company Spinnaker Health, whose 160 members recently voted unanimously to join Circle, hopes that GPs will play an active role in developing ‘more secondary work in the community’.
‘If you’re happy to continue doing your general practice and nothing else, that’s fine. If on the other hand you want to get involved with Circle national partnership to create new care pathways, you’ll be rewarded through shares.’
Like Circle, Assura is another firm offering GPs shares in return for joining up. But GPs who work with Assura do so through locally agreed Limited Liability Partnerships, with profits split 50/50 between GPs, who have full control over clinical services, and Assura, who provide administrative and IT support.
Although it has been at the centre of national patient protests about privatisation of the NHS, Sir Richard Branson’s Virgin Healthcare is another firm that says it will allow GPs to keep their GMS contracts while offering them a share of profits from other paid-for-services in their new polyclinics.
Other firms such as Serco and Care UK employ large numbers of GPs in a range of settings, but say they are also open to partnership agreements.
Dr Mark Hunt is managing director of primary care services at Care UK, which claims to offer ‘a pipeline of doctors at PCTs’ disposal’ and has been involved in APMS services, independent sector treatment centres and out-of-hours services.
No free lunch
But some GPs believe getting into bed with private firms will mean giving a way far more than just administrative headaches. ‘There is no free lunch here,’ says Dr Chaand Nagpaul, GPC negotiator and a GP in Stanmore, Middlesex.
‘While companies have a variety of ways of getting involved in general practice, including those that appear not to be predatory, all of them have a longer term agenda behind the initial innocuous offers.’
Dr Nagpaul also warns GPs who enter into salaried arrangements with private companies will be subject to ‘highly variable’ terms and working conditions, ‘very much subject to market forces’.
Dr Richard Fieldhouse, vice chair of the National Association of Sessional GPs, cautions that the initial ‘squeaky clean’ image of private sector employment might not be the reality in the long term. He says: ‘The problems we get with salaried GPs tend to be two to three years down the line, when they’ve not had pay rises, and practices are unilaterally changing contracts and really pushing the limit.’
Dr Fieldhouse’s claim is fiercely denied by the likes of UnitedHealth. A spokesman for the company says it aims to make the transition for GPs into the private sector ‘as seamless as possible’, including following BMA guidance on salaried GPs.
GPs who shun any form of commercial partner may at least have to commit to collaborating more with their colleagues, with the Government increasingly looking to larger more financially robust providers.
The offers:
- Currently largest partnership of clinical doctors in the UK. Says services could include telehealth, enhanced diabetic services, urological services, day case surgery, endoscopy, community-based ENT or ophthalmic services.
- GPs continue on normal contracts, and can either develop additional services with Circle’s help or act as ‘sleeping partners’
- A welcoming gift of 300 shares in the company each year, (which currently have a nominal value of about £3.50)
- A non-repayable grant of £2.00 per registered patient, to be spent on additional services to be pursued jointly with Circle.
- Locally agreed Limited Liability Partnerships (Assura GP Provider Companies)
- Profits split 50/50 between GPs and Assura
- GPs run clinical services
- Assura provides accommodation, IT and data storage, back-office support and bidding expertise, and incurs any potential losses
- GPs retain existing terms of contract and offered new premises
- A profit-share from other paid-for services in Virgin Health centres and extra quality payments.
- Virgin will employ all non clinical staff.
- GPs and staff will have to undergo Virgin customer training and be subject to a Virgin quality framework.
The salaried option
- Private companies employ GPs under APMS contracts
- Private firms currently employing GPs under this model include Chilvers McCrea, Care UK, Serco Health, United Health and Atos Healthcare
NHS Posts:

Enemy Of The People: NHS, Internal Market & Safety Net

Local Authorities: NHS Reform & Iceland

NHS: Changes Or A Conspiracy Against The Public Interest

1 comment:

Anonymous said...

they should lookinto the assura company few years the poor buggers who worked for them and they treated dreadfully! its been a complete mess and they are incompetant cutting need to talk to the staff!!!