PRIMARY CARE PCT looks outside NHS to tackle family doctor shortage

Published: 11/08/2005, Volume II5, No. 5967 Page 9

The first surgery in the UK at which a company is being paid to provide full NHS family doctor services has opened in an area of London with major GP recruitment problems.

Despite offers of 'golden parachutes' and enhanced terms and conditions from City and Hackney teaching primary care trust, chief executive Laura Sharpe said it was very difficult to recruit GPs under conventional contracts to work in run-down inner city areas.

Last year the government introduced legislation to allow companies to bid to run practices and provide the whole range of NHS services under the alternative personal medical services contract.

Now, 12 months on, private company Chilvers-McCrea has taken over a surgery in Hackney's Allerton Road. The surgery has been closed for three years because the PCT has been unable to fill the post left vacant when the GP retired.

Ms Sharpe said the PCT had tried to recruit a conventional GP through three rounds of national job advertisements without success. 'It was then we decided to put out a tender under APMS, ' she said. 'We didn't offer special incentives and made it clear that the contract would be awarded at the same rates we would pay under normal NHS arrangements.

'We specified that the bidders would have to provide the basic NHS contract plus eight extras - including diabetes care and screening and things like warfarin management.' Ms Sharpe said she hoped the introduction of APMS would be a catalyst for change among existing GPs.

'I would hope they would see what is happening and gang together in APMS-type things.

A GP working at Allerton Road said one of the things that made him want to work under APMS was that he could devote all his time to medicine because all the management and support has been worked out.' She said she was not certain how many of the 'big' private medical providers would want to get involved in providing GP services. 'Primary care is messy and expensive - the door is now open, but who comes through is another question.' Chilvers-McCrea chief executive Dr Rory McCrea, who is a GP, said early indications are that patients were pleased with the service and had seen a 'seamless' change fom NHS to APMS: 'The key thing with APMS is to find out if it can deliver a better service for patients.' Dr McCrea added: 'We will take a good six months to a year to bed the practice down and we will hope to expand the service in line with what local people want.' NHS Confederation APMS advisor Tom Easterling, primary care development manager for north central London PCTs, said the Hackney project was 'important symbolically because it is in an indication that PCTs are serious about bringing other people in to provide primary care'.