GP Services - Scenarios

Introduction

General Practice (GP) services are the services provided by doctors and nurses for treating patients with common medical conditions. They refer patients to hospitals and other medical services when they need urgent or specialist treatment.

In order to deliver services, all GP Practices have a contract with the NHS, which sets out what services they provide and how much they are paid. Some of these contracts have a fixed date on which they finish. This means that, unless a new contract is agreed, the service they provide will end on this date.

 NHS Coventry and Rugby Clinical Commissioning Group, which plans and pays for health care services in the area, is responsible for managing these contracts. Our goal is to make sure that we deliver high quality services for our entire population, which make the best use of the resources that we have. This means that we need to consider where GP services are located, how easy they are to access, and whether they are able to provide the care that patients need, both now and in the future.

Your GP services are currently provided through a contract which comes to an end in March 2020. This means that we now need to consider what happens to the service next.

There are several possible scenarios. We can:

  • Offer a new contract to deliver services in the same way from the same location. We would then look for a provider who wants to deliver this contract
  • Put this contract together with other contracts in the area which finish at the same time. We would then look for a provider who could deliver the contracts as a group, while keeping services in their current locations
  • Do not offer a new contract and support patients to find other local GP practices from which to receive services.

Each of these scenarios is explained in more detail below.

We are not able to keep things as they are, because we have a legal obligation to offer the chance to bid on any new contract to all providers who are interested to ensure services continue to improve and offer the right support for patient needs. Your current GP contract holder will be able to bid on the contract if they want to.

In all scenarios, the current provider will continue to provide GP services from your practice until March 2020. No decisions have yet been made on the future of the service, and you do not need to do anything to change your GP Practice. If changes are made, you will be kept fully informed.

Possible scenarios for consideration

Offer a new contract to deliver services in the same way from the same location

In this scenario we would try and find a new provider for the service. Providers for the contract could include commercial providers, not-for-profit organisations, voluntary and community sector organisations and other NHS organisations, as well as groups of interested GPs.

All providers who are interested in taking on the contract will bid for it through what is known as a procurement process. As part of this process they will have to demonstrate their plan for providing a high quality service, and prove that they are able to run a service that is suitably staffed and clinically safe. We would include patient representatives in the procurement process, so they can make sure the views of the patients are fully considered.

Following the end of the process we will select the provider which we think is best able to deliver an affordable and high quality service. If this is a new provider, they will work with the current provider to be ready to start delivering services from the practice in March 2020. If the current provider chooses to bid for the service, and wins the contract, they will continue to operate from the practice as before.

It is possible that, following the procurement process, we will be unable to find a provider who meets the standards necessary to ensure you get the best possible care. In this case, we would not award the contract to anyone. It is also possible that we would not receive any bids for the service and be unable to find interested providers.

In both these cases, your GP Practice would close in March 2020 and we will support you to find another GP in your local area. 

Pros

  • If the process is successful, there will be the least change for you as a patient. You will continue to receive your GP services from the same building, although the practice staff and doctors may change.
  • Through the process we will be able to select the provider who can deliver high quality services for the best value, making sure that we spend our limited resources wisely whilst providing you with the best care.
  • Patient representatives and local residents can be included in the procurement process, supporting us to find a provider who can best meet the needs of local patients.
  • We will have the opportunity to update the contract before we start the procurement process. This could include additional requirements to improve the quality and performance of the practice based on patient need.

Cons

  • We may be unable to find a suitable provider for the contract. If this happens at the end of the procurement process, we will only have three months in which to support you to find another practice before the service finishes in March 2020.
  • The process could be unsettling for staff, which may lead to them leaving the service. This could have an impact on whether you are able to see the same doctor or nurse.
  • We will need to go through the same process again in five years. This costs the NHS money and resource.

Put this contract together with other contracts in the area which finish at the same time

We could choose to combine this contract with other contracts in the area to make one larger contract. This contract would be to deliver GP services from a number of different locations, including your current practice. Larger contracts like this are more cost-effective to run, as you can share staff and support between the sites, which might appeal to more providers.

If the contracts are combined, we still have to follow the procurement process described in the previous scenario. The possibility remains that, following the procurement process, we may be unable to find a provider who meets our standards. In this case, we would not award the contract to anyone. It is also still possible that we would not receive any bids for the service and be unable to find interested providers.

In both these cases your GP Practice would close in March 2020 and we will support you to find another GP in your local area.

Pros

  • If the procurement was successful you would still continue to receive your GP services from the same building, although the practice staff and doctors may change.
  • A larger service would have the opportunity to recruit a wider mix of staff to cover all the sites. This could include more specialists and improve the range of service available to you from your GP Practice.
  • Small sites which don’t have as many patients are more likely remain open as a part of a larger service, when they might not be large enough to attract providers alone

Cons

  • As part of a larger service, staff may be rotated around a number of sites or shared. This may mean you are less likely to be able to see the same doctor or nurse when you want to.
  • Staff working across a number of sites could impact on service quality, as they are less connected to a single site.  
  • We may be unable to find a suitable provider for the contract. If this happens at the end of the procurement process, we will only have three months in which to support you to find another practice before the service finishes in March 2020.
  • The process could be unsettling for staff, which may lead to them leaving the service. This could have an impact on whether you are able to see the same doctor or nurse.
  • We will need to go through the same process again in five years. This costs the NHS money and resource.

 Do not offer a new contract and support patients to find other local GP practices

 In this scenario, we would not try to find a new provider for any type of contract, and your GP Practice would close in March 2020.

 We would support you to find a new practice in your local area which is suitable for you and meets your needs.

Pros

  • You will have the most possible time to select a different GP who is suitable for you.

Cons

  • You will no longer be able to receive services from your current practice 
  • You may not be able to find another GP practice which meets your needs in the same way that your current practice does.
  • Other practices in the area might suffer from a sudden big increase in size as new patients register. This could make it harder to get an appointment.

How do I share my opinion on these scenarios?

We are asking patients in the surgeries with contracts which are coming to an end to fill in our survey, which will help us to understand what matters most to people in the services they receive and what impact changes would have. The survey can be found here – https://www.surveymonkey.co.uk/r/CovGPServices

If you would like to discuss the scenarios in more depth, we will be working with the Patient Participation Group (PPG) at your practice to explore each scenario and what it might mean for you. Please speak to your reception staff to find out more about your local PPG and how you can share your thoughts with them.

How will your feedback impact on our decision?

We want to hear your thoughts on these scenarios, and what is most important to you in the GP Services which you receive.

We will use your feedback, alongside other information available to us, to help us make a stronger, more informed decision of which scenario to go for.

We will let you know our final decision in good time, including how your feedback helped us make the decision, or why we could not go with your preferred scenario.

What will happen if the scenario you want isn’t the one selected?

Your views and input will be considered alongside a number of other factors, such as quality and viability of the service, availability and suitability of providers and finance, as highlighted in this document.

We will explain the rationale for our decision taken and, if there are changes, work with affected patients to mitigate the impact.

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