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FAQ's

The new federation has a structure based around practice membership and not specific companies. These companies have practices which are part of HMR, and have decided to join us because they feel that our legal structure is supportive of holding HMR wide contracts that might become available under neighbourhoods that may impact them. None of these companies hold any controlling rights beyond that of their practices’ participation in our new federation. One of the benefits of each of these is they have the potential to bring experience and expertise to the federation, as well as providing financial strength / trading history that is usually required to be demonstrated when we bid for future tenders. They will only participate in service delivery when formally invited to do so by the federation board.

The federation will be an organisation of participating member practices. Membership does not alter the PCNs which continue to operate under the existing DES and memberships with any agreed services unchanged. Whilst there would be no change by joining, there may then be an option for PCNs to request the federation to hold contracts, should this be agreed by both PCN and federation. It is unclear at present how quickly the new neighbourhood contracts will be available and impact on PCNs. Having a jointly owned and run legal vehicle means an option to bid for contracts if they were moved from PCN's into a wider contract process as part of neighbourhoods. Otherwise, the default would be that these move to those able to tender through legal companies.

Decisions on all contracts would be made by voting of the federation but acts on a principle of non-competition between member practices.

As the new neighbourhood information has come out in the last few months it has become clear new contracts have to be held by a legal entity. Today, unlike other regions, there is no option in HMR to hold these jointly that everyone would agree would do this in an independent and financially transparent way. Therefore, a desire to set up something new has evolved. This means practices will be joining at different points along this journey, but it is a journey for all those involved. Early decisions were exploratory and based on who was already engaged in neighbourhood planning, but a critical number has now been reached such that we are formalising and making this as a specific offer for all practices to have membership to join, as with any federation.
No. As we outlined in FAQ 1 the aim is to provide a Federation that is owned by its members, for its members, that meets the needs of the new neighbourhood contract challenges coming our way. Having very few options available for commissioners on legal entities that could hold new neighbourhood contracts is not a good place to be. However, having an option that practices can join and be part of to hold these new opportunities especially where majority of GP practices in the area have joined, is a strong proposition both for practices and patients.
The primary decision on how required PCN DES services are provided will remain with the PCN. Where a PCN requests the federation to support in providing such requirements, a proposal will be drawn up with clear options and financial transparency and where agreed these could be provided by the new federation.
One of the founding principles is that surpluses are reinvested locally and not distributed as dividends. Any reinvestment will be by agreement from member practices. The purpose of the Federation is to enable and facilitate the funding to continue to flow direct to local practices or the PCNs. Within the Neighbourhood model, large contracts are likely to be held by organisations such as the federation and therefore the HMR Integrated GP Federation’s stated aim is to make this available to the practices, not withheld for the purposes of dividends. This will enable faster and more transparent practice funding rather than federation surpluses.
The aim is less work, less cost and shared risk. If any individual practice was looking to set up a similar type of legal vehicle to tender for, and hold future contracts itself, they would face a five-figure cost in professional fees with the risk of being unsuccessful in tendering. Collectively coming together increases the chances of success by being seen as the HMR GP practice supported organisation in the area at a fraction of the cost and/or time. The new neighbourhood model will mean all practices will have to invest some time as the government reform progresses. With a federation in place however, there will be a source of collective knowledge and ready functioning legal organisation to act as a holder of future contracts that will operate at the control of members.
Integrity and transparency are two of the founding values, therefore having a strong governance framework including handling conflicts is key. All members will be expected to declare on an interests register, their specific potential conflicts and ensure this is kept up to date. Where a proposal is presented to members with a potential conflict of interest, it should be presented by a non-conflicted member to avoid any implicit bias. Any cases where a dispute arises will be overseen by an independent chair appointed by mutual agreement.