Multi Speciality Community Provider (MCP)
Voluntary Contract Framework
As I indicated in my recent email this framework has now been published. This would allow groups of practices working together and with other partners to hold a budget based on a population to deliver care in a more integrated way.
In Wessex there has been a lot of work to try and develop better services for patients including the Vanguards in the Isle of Wight, North Hampshire and Farnham and in Southern Hampshire. There are other areas such as Dorset and Southampton who were not part of the initial Vanguard programme but have joined the process of transformation of services across providers.
Following the announcement at the Conservative Party Conference last year that there would be a new deal for general practice there has been much speculation about what this would include and how much freedom it would give practices.
For the NHS to meet the demands that it faces with an ageing population and more people who have one or more long term conditions, continuing with the over dependency on hospital based care will not only be unaffordable but will also compound the problems faced by community services and general practice.
I have told you before that the NHS needs to build on the strengths of general practice, with the registered list of patients and also, where appropriate, the unique strength of continuity of care that general practice offers, but this is not enough. There needs to be greater investment, flexibility, and joint working in the community to deliver a balanced model that is sustainable. To achieve this, general practice needs to play a lead role as we account for about 90% of the daily patient contacts.
The Voluntary Contract will be based on a defined population and will require general practice to be at the core of this work. Without the registered list this will have little impact.
The contract will need to be held by a legal entity which could be a Limited Liability Partnership (LLP), a Limited Company, a Community Interest Company (CIC) an NHS Trust or a Foundation Trust. This will be a population based contract with a defined budget giving greater freedom to the providers in terms of the design and delivery of care, breaking down the barriers between general practice and community staff.
Some have said that this contract will mean that practices will have to give up their GMS or PMS contract and therefore is a major threat to the profession.
I sit on the national advisory committee for the New Voluntary MCP Contract and Hampshire is one of the six pilot sites. I can assure you that those practices who want to retain their GMS or PMS contract will be able to do so. For some, as has happened in Gosport, moving to an employed model where this is in the best interests of the practice, the option will also be available.
In addition, if a practice does not want to be part of the contract they can remain outside it but will need to accept that services for their patients will be developed at a population level. Clearly if lots of practices opt not to take part in the contract, it will not go to procurement.
To find out more information follow the links below:
LMC webpage for MCP Voluntary contract - click here
You will find the published framework, the BMA's Focus on document responding to the framework.