GP Practices Forced to Demonstrate Ability to Manage Risk in Contract

NHS England has indicated that it is essential for GP practices to demonstrate that they can “manage reasonable downside risks”before signing up to the new voluntary contract from April.

All GP practices will be tested by NHS England and NHS Improvement to decide whether they are financially stable enough to take on the new contract, according to a draft of the new document that has been distributed among media.

This new voluntary contract will be enforced fom April 2017 for practices working in a new model of care, and for all others in groups of 30-50,000 patients in 2018.

The aim is to deliver “a much broader range of services into the general practice model”.

Former Prime Minister David Cameron had introduced this new approach back in 2015, with the intention of increasing funding and particularly reducing bureaucracy.


Practices have the option of signing up in various ways, including a GP-owned company, a federation or as a joint venture between practices and a trust.

GPs can also individually join an MCP as employees, with existing NHS bodies, like foundation trusts, holding the contract.


However, there are specific requirements included within the contract that GP practices will be required to meet.

For example, every provider that submits a bid for a contract will have to prove that they can ‘manage reasonable downside risks’ according to the draft.

The level of financial security will be laid out in the form of an ‘integrated support and assurance process (ISAP)’ that will be run by NHS England and NHS Improvement.

This will be drawn up by commissioners who will determine how financial risk to the MCP will be managed.

The consensus of opinion is that general practice faces massive challenges in the coming years.

Surveys have indicated that 35% of GPs are considering retirement in the next five years, while the greying population in the UK will put further pressure on everyday surgery in the coming years.

Meanwhile, general practice is just one area of the healthcare system likely to be impacted by a general push for spending cuts.


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