MCP – more change please

Suffolk GP Federation recently presented its thoughts on the new Multispeciality Community Provider (MCP) contract at a special healthcare event at the Trinity Park Showground in Ipswich (slides available here).

We followed a presentation by Tracey Vell, Chief Executive of Manchester Local Medical Committee (LMC) and Lead for Primary Care in the Greater Manchester Health and Social Care Collaboration. Tracey described what they had achieved as part of their so called ‘Devo Manc’ Project.

My thoughts on Tracey’s presentation were:

  • What a lot of money! They had £450 million of transformation funding over five years for 2.8 million patients, the equivalent of £32 per patient per year.
  • General practice needs a louder voice. As a provider, it is vital that our views are heard. That’s exactly what Suffolk GP Fed is doing – representing the opinions of GPs and practice staff at all levels. But we also need to work together, collaboratively, with the LMC and CCG to provide a single, unified voice.
  • It is vital that primary care is involved in top-level discussions.
  • Some of the innovations described are already happening here in Suffolk. GP+, which provides extra doctors’ appointments for patients in the evenings and weekends, career development programmes for GPs and practice nurses and locality hubs (currently working in Felixstowe but with plans also in place for North West Ipswich) are all under way.

I know some colleagues felt the Federation’s presentation was somewhat downbeat. But my main aim was to make clear that the MCP is not a ‘White Knight’ that is going to rescue Suffolk practices from the severe pressure they are under.

My reasons are:

  • It is very unlikely Suffolk will be given huge amounts of extra money and any resources will need to come from efficiencies made in the delivery of services e.g. community health, outpatients etc. This is very risky and may be unlikely.
  • MCPs may influence members to delay their plans for being involved in other collaborative work which is already progressing.
  • The promise that MCPs are a ‘third way’ from Personal Medical Services (PMS) and General Medical Services (GMS) seems unlikely.
  • There are other ways of achieving similar outcomes to the MCP by collaborative working with community providers in Accountable Care Organisations or Integrated Care Organisations.
  • It may actually be too much change, particularly with the pressing need for primary care to work at scale in a bid to address workforce and workload issues.

So, what is the Federation’s approach?

  • Engagement at high level. The Federation is representing primary care’s voice in the Strategic Transformation Plan covering North East Essex and Suffolk and at the Suffolk Accountable Care Organisation (ACO) or Integrated Care Organisation (ICO) meetings. We are looking at alliance working with key players, secondary care, social care, Norfolk and Suffolk NHS Foundation Trust and community services. Positive messages are emerging, although we are still waiting to understand the full detail.
  • Increased resilience. I do feel there are ways general practice can operate differently, particularly by taking advantage of our wide skills mix and coming together to be more efficient. This is often easier done with practices working at scale e.g. making better use of pharmacists and Emergency Care Practitioners. To help facilitate this, the Federation is supporting various collaborations that are now starting to appear across Suffolk.