Handing Back Your GMS/PMS Contract: A Guide
There has been much discussion in primary care circles about practices “handing back” their contracts as a way of getting out of challenging situations. This is increasingly common and there have been a number of high profile instances across Scotland where practices have done precisely this.
But what does it all mean and is it as simple as is made out?
When practices talk about “handing back” what they normally mean is bringing their GMS contract to an end. It is a serious decision for the practice concerned and, almost inevitably, will result in the end of their business with all that flows from that.
This creates a problem for the Health Board concerned; provision of primary care to the population is a fundamental obligation on Health Boards. It becomes the Health Board’s issue to ensure that the affected patient body is adequately provided for.
The standard GMS contract does allow the contractor (i.e. the practice) to give notice of termination. The notice period is normally six months which in theory gives the Health Board time within which to retender for the provision of primary care to the practice’s patients. Some practices have gone down this route and, whilst it can be complex and potentially painful, it does nonetheless allow things to be dealt with in an orderly manner.
More often, however, a practice will be in a position where matters cannot be dealt with in an orderly manner. There can be various drivers for this but I have seen illness, inter-partner disputes, recruitment issues, GMC disciplinary issues and cash shortfall all contributing to this.
Some practices have simply stopped practicing on little or no notice causing real difficulties for all concerned.
There is unlikely to be a legal right for a practice to do this and it leaves the practice in breach of their GMS contract and thereby liable for damages.
However, depending on the circumstances, the Health Board may be willing to foreshorten the timescales and/or work with the practice to find a resolution. Remember, however, that there is no obligation on them to do so and, whilst the Health Board will take active steps to provide for patients, they will have little regard for the practice as a business or the personal situation of the individual partners.
The issues for a practice are not limited to the status of their GMS contract. In my next blog, I will look at some of the matters a practice should take into account if they are considering whether to hand back their GMS contract.
Whenever a practice is considering handing back their GMS contract the partners should take professional advice as to how best to do that and whether there are steps they can take to protect their position.
Davidson Chalmers Stewart has extensive experience in working with practices facing these issues and can provide sensible tailored advice which may prevent an already difficult situation turning into a catastrophe. For an initial informal conversation please contact me at firstname.lastname@example.org (0131 625 9191) or speak to another member of our specialist healthcare team.