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GPs buried under trusts' workload dump

CCG to put all local enhanced services funding through PCNs

Exclusive A CCG in London will gradually funnel local enhanced services payments into its primary care networks (PCNs), Pulse has learned. 

NHS Newham CCG developed a local scheme for its 10 PCNs to supplement the networks contract DES, which will see funding progressively go to the networks over five years.

This comes after Dr Zuhair Zarifa, former Newham CCG chair, previously told Pulse that practices in the area had to federate or face the loss of local enhanced services worth 15% of their practice income at the time

Local enhanced services in Newham were known as extended primary care services, themselves later 're-badged as the Newham SNS'.

The supplementary network services (SNS) programme, launched in Newham alongside PCNs on 1 July, will see the networks achieve certain targets through the delivery of 14 services over five years.

GP leaders have warned the scheme will only result in increased health inequalities. 

Under the SNS, the proportion of funding delivered to PCNs will rise year on year based on the PCN outcome target. 

In the first two years, payment will be made to individual member practices that meet SNS targets, while in years three, four and five the network will be required to achieve the targets before their network can claim payment. 

In future years, the proportion of funding given to practices will shrink. In 2023/24, all funding will go through networks. 

A spokesperson for Newham CCG said: 'The CCG has commissioned a SNS programme from its PCNs since 1 July 2019. It covers 14 services and will be monitored at a network level with payment tariffs comprising two components – a proportion based on activity delivered and the remainder based on achievement of a PCN outcome target.

'The programme builds upon a historical commissioning of these services from individual GP practices. It is anticipated that an approach that involves networks and their constituent practices will deliver a reduction in the unwarranted variation in service delivery that our patients in Newham have experienced to date.'

Dr Farzana Hussain, a GP and PCN clinical director in London, said the SNS programme will be challenging, given staff shortage issues, and increasing health inequalities at a time when general practice is already creaking under increased patient demand. 

She said: 'The introduction of the SNS this year when PCNs are just forming and relationships need to be nurtured and built, is in my view, too early. 

'Practices providing higher outputs at present will also lose money through the network not achieving as a collective and therefore there will be fewer resources to help already struggling practices. This can only increase the health inequalities that are present and our most deprived populations lose out.'

Readers' comments (6)

  • if they don't provide the funding don't do the work. you are running a business not a charity. The more we stop providing freebies the more likely we will get properly paid for them in the long term. it may go to a private company for a while but once they go bust it will come back to you and you can charge a higher fee. simple economics. you are not helping your populations by providing services unpaid, wearing your staff out so that they leave and the patients end up with no service at all.

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  • This is government agenda to get rid of smaller and independent practices. Also the CCGs will be funding less amounts as compared to what they would have funded practices to deliver. Say a no to everything and then ask them to explain through FOI, why there are happy to give more money to secondary care.

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  • how on earth did the CCG membership allow this? were they asleep?

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  • National Hopeless Service

    when PCNs fail or are changed again best of luck unpicking the mess.

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  • This PCN contract just gets worse and worse. Did the BMA not see this sort of thing coming?

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  • Can Pulse please ask Londwide LMCs what they are doing about this? This diversion of front line GP funding into unrpoven collaboratives without any legal structure is a disaster waiting to happen, and can't be allowed to happen.

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