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Cameron’s contract crew

Last autumn the prime minister announced that general practice was to get a new “voluntary contract option”, to accelerate and support the development multispecialty community provider type arrangements. David Cameron also claimed it was a way to help extend GP access outside office hours.

In the GP Forward View last month, NHS England said six areas were “working intensively with us to complete the design of the contract”, with the intention of going live with practices “on a voluntary basis” next April.

It has since been renamed the “MCP contract”, and on Tuesday HSJ was able to reveal where those six areas are:

  • Dudley;
  • Better Local Care (Southern Hampshire);
  • Manchester;
  • Modality (Sandwell and Birmingham);
  • West Wakefield; and
  • Whitstable, Kent.

Modality is a super-partnership GP group with a patient list of more than 60,000, while Whitstable Medical Practice has a list of 35,000. The four other areas are dominated by looser groupings of independent practices.

Other MCPs are considering taking on the contract but are not in the group of six working with NHS England.

The major challenge in introducing the new arrangements is expected to be persuading practices to give up their GMS and PMS contracts, which are held in perpetuity. Officials have been exploring how to offer a guarantee GPs could return to their previous contract if they were to change their mind.

Dispute amid Cumbrian fog

The Cumbria success regime has rejected as “absurd” concerns raised by governors at Cumbria Partnership Foundation Trust over its plans for community hospitals.

Claire Molloy, the trust’s chief executive, has also downplayed her governors’ concerns and said no concrete plans have been made by the regime.

The governors accused the success regime of seeing services at the community trust as “a cash cow to solve problems in the acute system” in a letter last month. This was in response to the regime’s February public progress report, which suggested inpatient beds at community hospitals could be focused on a smaller number of sites or developed as community hubs without inpatient facilities.

The success regime had a different view, with a spokesman saying: “It is absurd to suggest that community hospitals could, on their own, offset the wider health community deficit.”

Ms Molloy, who is also on the regime programme board, told HSJ the trust’s directors did not agree with its governors. Echoing the regime spokesman, she added: “The total budget for our community hospitals doesn’t go anywhere near the financial gap.”

She also rejected the governors’ accusation that the regime lacks transparency. In the letter they said the success regime was mired in “impenetrable fog” on almost every issue.