But there are others who aren't going to want to commit to the personal and financial risk. There is also a lot of potential for cross cover and benefits around mutual support, training and governance.’ Contractor modelīut she warned that the same approach would not necessarily work for others and that it should not be mandated nationally. She said: ‘I think it would be a mistake because there are some people who want to have a more traditional model. There's potential for people to move around so we don't lose them from the area. It's all sorts of things, but it's been a well thought-through process for each practice. 'There may have been difficulties with premises, with recruitment, or with management. GPs are able to keep their names on the contracts and hold the contract - but they are employed by Northumbria Healthcare, the trust foundation.ĭr Lothian said that the model had proved successful in her area due to ‘long-standing relationships’ between practices, and the combination of successful and struggling practices working together. She said: ‘Each practice has joined for a different and very genuine reason. Under the Northumberland model, all GPs working for NPC are salaried - with each practice having a site manager and one senior manager. Last month Mr Javid also backed a health think tank report that called for the end of the GMS contract within a decade, with GPs becoming predominantly salaried. Her warning follows reports from earlier this year that health and social care secretary Sajid Javid had told the prime minister that general practice should be effectively nationalised - and that all GPs should be directly employed by hospitals. However, Dr Lothian warned that enforcing vertical integration across England would not fix the individual problems of practices up and down the country - adding that it could in fact 'alienate' those who are struggling the most. She said that the model, which was one of the first of its kind in England, had improved retention by allowing clinicians to move between practices and had brought other benefits, such as shared governance and management. Northumberland LMC medical secretary Dr Jane Lothian, who helped establish Northumbria Primary Care (NPC) in 2015 - a group of seven practices subcontracted to the local foundation trust - told GPonline that 'vertical integration' of the GP surgeries with the hospital has increased the sustainability of practices in her area.
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