Community providers gear up to lead on new care models

Two trusts and a social enterprise have told HSJ they are likely to submit expressions of interest to NHS England by 2  February to be included in the “vanguard” of sites setting up prototypes of the forward view’s “multispecialty community provider”, or MCP, model.

The document indicated that MCPs would be formed through GP practices scaling up and providing an extended range of services, including community services and some specialist inpatient provision, rather than via community service providers moving into primary care.

However, HSJ has learned that some community service providers believe they are better placed to lead the formation of an MCP.

Katrina Percy, chief executive of Southern Health Foundation Trust, said her organisation was planning to submit an expression of interest alongside some local primary care providers.

While the trust’s intention is to establish an MCP covering its core footprint of Hampshire, she said how this is constituted will vary across the patch, depending on existing primary care.

This could lead to the trust setting up joint ventures with the practices most ready to adopt new models, or buying out other practices and employing GPs directly on consultant salaries. The latter option could be used in areas with fewer doctors or where recruiting GPs has been difficult.

Ms Percy said Southern Health is in “quite advanced” negotiations with GPs in four areas, and was confident more would offer to set up a joint venture.

As Southern Health provides both community and mental health services, she said services for people with long term mental illness would form an integral part of the MCP offer.

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Ms Percy said the new organisations would benefit from working on a large scale – her own core patch has a population of 1.3 million.

“You need to be sharing infrastructure and back office costs across a large patch. Also at scale you become an equal partner to the acute trust you’re working with in that health economy – whereas if all the MCPs are serving 50,000, an acute trust would have to work with 20 little MCPs – that’s really challenging.”

Robert Flack, chief executive of Locala Community Partnerships, a social enterprise providing community services to 400,000 people around Kirklees, Yorkshire, also confirmed his organisation would submit an expression of interest to be included in the “vanguard”.

Locala already has a GP list of 15,000 people, and is now looking to take over more practices or enter into partnership with GPs to develop an MCP.

He argued that community services providers operating across large populations are better placed than GPs to establish an MCP. “Organisations like ours know we need to accept the challenge to change, but for GPs to come together and create an organisation and deliver in a very hard environment, where those organisations don’t already exist, is an awful lot of leaps.”

Kent Community Health Trust is also keen to lead an MCP. Chief executive Marion Dinwoodie told HSJ it was “highly possible” that her trust would submit an application for the vanguard. “We would absolutely see ourselves as a key player in whichever [organisational forms] appear,” she said.

“We want to do is carry on being a direct lead provider,” she said, either through directly employing GPs or through entering into joint ventures.

HSJ also understands the NHS Confederation’s Mental Health Network is working with a further group of trusts also hoping to be included in the first wave of areas pioneering new models of care.