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Petra Westlake

BLOG: NHS vanguard programme incorporates contract options for GPs


Under the new vanguard programme to transform the NHS, GPs may be given the option to revert to GMS or PMS contracts if the collaborations are not successful, GP Online has reported.

To attract GP practices to form integrated care organisations with hospitals under new care models, GP Online reports that health service leaders in Somerset are developing plans which will allow GPs to revert to their previous contract.

The plans, which are intended to make integration less risky and more attractive to GPs, are being discussed by leaders of the South Somerset Symphony Programme* and the national primary and acute care systems (PACS) vanguards programme with the view that new care models can only be successful if they are based on voluntary partnerships.

To achieve this the plan in Somerset is to form an integrated care organisation, bringing practices together with a hospital trust, with an integrated provider employing the clinicians.

Symphony programme board chairman GP Dr Berge Balian told GP Online: "The model we envisage is that we develop an integrated care provider organisation that will have the ability to hold GMS and PMS contracts.”

"Some practices might choose to take their GMS and PMS contracts and integrate with that provider organisation. But what we are working on at the moment is how to do that and still allow those partners to in effect hand over their GMS or PMS contracts to that provider organisation, [but] then take that back in the event that the PACS-vanguard fails for whatever reason.”

Somerset CCG is developing a new commissioning model for the integrated commissioning provider organisation which will be based on outcomes. The integrated contracts being developed will be similar to current GP capitated contracts, moving away from the item of service contracts for hospitals. However, local practices that choose not to join the integrated organisation could still work with it on specific elements of care while retaining their independent contract.

Somerset is one of nine primary and acute care systems vanguards across England, with the practical details of how integration works remaining undecided. NHS England national lead for PACS Jacob West said: "We are reasonably governance agnostic about the approach. First and foremost is doing the design work on the care model then finding a governance vehicle that locally helps you deliver that.”

Dr Balian pointed to Somerset as a good example of how they are working through the programme’s technical issues. He points to issues in the new model such as contracting, payment mechanisms, organisational form, workforce redesign, and role of technology which all need to be resolved as part of the integration programme which will initially focus on 1,500 patients with multiple long-term conditions.

You can find out more about the NHS vanguard sites using NHiS Investigator Online, visit the NHiS website for more information.

*The South Somerset Symphony Programme brings together South Somerset Healthcare GP Federation, Yeovil District Hospital Foundation Trust, Somerset CCG, and Somerset County Council.

This is just one in series of blogs written by Petra Westlake at NHiS. To view more, visit

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