A new GP-owned company is to provide NHS services in the community from April. Innovations in Primary Care (IPC) is owned by the 18 GP practices in Worthing and Adur on the south coast.
The main motivation of IPC's six founder members - five GPs and a business manager who are now its directors - is to prevent non-GP organisations from gaining alternative provider medical services (APMS) contracts in the area.
We are hoping to provide dermatology outpatients, rheumatology, family planning, anticoagulation, referral management and minor surgery. Further down the line, we want to move into diagnostics and other secondary services and build our own treatment centre.
Now tendering for IPC's first contracts with Adur Arun and Worthing PCT, the six of us have been brainstorming since last summer in anticipation of last month's White Paper on primary care.
IPC's chairman is Worthing GP Dr Bruce Allan, a West Sussex LMC member and lead for specialist PMS at Adur Arun and Worthing PCT.
The other directors' local roles include Adur GP Dr Patrick Feeney's chairmanship of West Sussex LMC. My practice is in Littlehampton and I am the LMC's deputy chairman. Worthing GP Dr Maurice Shipsey is new contract lead at the PCT and chairs the Worthing Practice Commissioning Group.
Dr Andy Thompson is PMS lead, while Sue Parton is business manager of two large local practices and former deputy chief executive of Adur PCT.
Last year, we drew up a proposal to form a company owned by local GPs that could become an NHS provider. We thought this should include enhanced services as well as some services that the local acute trust is struggling with.
The company is looking for 'easy wins' to start with, providing services in existing GP premises. It will not compete with its members who will have first refusal of enhanced services. The company, however, plans to organise anticoagulation, minor surgery and dermatology services.
Its aim is also to provide Choose and Book and referral management services for the 18 practices. If the referral management scheme goes ahead, Choose and Book will be taken out of the surgery.
Before Christmas we invited the practices to a presentation. They all declared an interest and the founders went off to set up the limited company, write business plans for the services to be provided, and draft a shareholder's agreement.
In the New Year, there was another meeting at which all practices declared an intention to sign up, and buy shares in the company. Under the shareholder agreement, the GP partners buy a £1 share per 100 patients.
The practices also lend a capital sum of £1 per patient for start-up and running costs. The loans will be repaid before any dividend income is paid to shareholders.
The six directors met the PCT at this point to present our proposals.
Forward-thinking director of primary care, Bob Deans, gave us the green light to proceed, with several suggestions as to how we can bring our plans to fruition.
The company now has a board of directors, is about to issue IPC shareholders their share certificates and has over £100,000 in the bank: nearly all the practices have bought their shares and paid over the loans.
Shareholding GPs can benefit in three ways. It is hoped that they will receive a dividend in the future. They will also be entitled to work for the company and be paid for that work. Thirdly, they will benefit from the savings made through referral management.
The scheme has the support of local GPs because it offers a way for them to protect their core business and retain their individual flexibility.
It also allows creative GPs to expand into the secondary care market, which under the White Paper proposals will be opening up to all sorts of competition.
- Dr Kimber is a GP in West Sussex
INNOVATIONS IN PRIMARY CARE LIMITED
- GP-owned company set up to provide NHS services.
- Its shareholders are its six directors and the GPs at 18 Adur and Worthing practices.
- Services the company plans to provide initially from shareholders' practice premises include anticoagulation, minor surgery and dermatology.
- It plans to operate Choose and Book combined with referral management on behalf of the practices.
- IPC allows enable GPs to enter the healthcare market and work together for mutual benefit, whether or not they engage with providing extra services.
- The White Paper means that primary care and elements of what is now called secondary care will become a competitive market.
- GPs are ideally placed to enter this market since they have expert local knowledge.