Exclusive: struggling GP practices may be classed 'cause for concern'

The national board is due to publish details of its operating model for commissioning primary care in coming weeks. Details of draft plans seen by HSJ indicate it will promise to stop “micro management” of GPs and other primary care providers.

The documents say that: “Relationship management, a risk based approach and a focus on outcomes will replace micro-management”, referring to the way primary care has been managed in the past by primary care trusts.

GP practices will be managed under a partnership between the board and the practice’s clinical commissioning group. It confirms that, while the commissioning board will be the contract holder, a practice’s CCGs will have a significant role in practice oversight.

The documents say there will be a “a strategic and operational partnership [between NHSCB and CCG] with a quality improvement focus”, and a “single shared conversation about practice performance with agreed action plans”.

It says the “primary relationship [will be] between CCG as member organisation and NHSCB (Not NHSCB with practices)”.

The documents say there will be a contract management framework with “a risk based approach that describes the NHSCB relationship with practices”. They say relationships will be split into three classes based on practice performance - “assurance based”, “room for improvement” and “cause for concern”.

The contract framework will include a “key indicator set” covering “patient safety, patient experience, clinical quality and organisational effectiveness”.

The documents say data should be used to “‘flag’; outlying or shifting practice”. They say “commissioner response or actions should be proportionate, reasoned and informed”.

Further details will be published soon by the NHSCB in Towards Excellence in Primary Care Commissioning.

The work is not intended to be a strategy for primary care, which will be developed later by the NHSCB and CCGs.