In October 2007, Lord Darzi reported that, despite sustained investment and improvement in the NHS, access to primary medical care services and the quality of those services continues to vary significantly across the country. Many of the poorest communities experience the worst health outcomes and the gap in life expectancy between the most deprived and least deprived areas has notably widened.
The Equitable Access in Primary Medical Care Programme was designed to achieve Lord Darzi's vision of a fair and personalised NHS while simultaneously upholding the values of safe and effective primary care services. The Programme set challenging targets for the delivery of two new streams of primary care procurements:
- at least 100 new general practices in the 25% of PCT areas with the poorest levels of provision
- in every PCT area, one new and easily-accessible GP-led health centre with opening hours between 8 a.m. and 8 p.m.
At Bevan Brittan, we acted on behalf of the three Strategic Health Authorities and individually for over 40 PCTs on a total of 90 new health centres and GP practices across the country.
We have negotiated and closed over 90% of these projects (a handful will be reprocured), advising on all aspects from procurement, the APMS contracts themselves, evaluation and selection, replies to FOIs (of which there were over 800 for one region), premises solutions (often involving both temporary and permanent solutions), as well as threatened challenges under procurement regulations. Of particular interest - and for the first time employed in primary care - is the use of a payment mechanism, linking quality to payment. This is a big step change from anything approaching “QOUF” payments. This new form of performance management is beginning to influence primary care contracting beyond equitable access itself, leading PCT to a more active management of their market of primary care providers to deliver on their strategic aims.