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GPs go forth

CCGs 'refusing to sign off' networks where unpopular practices have been left out

EXCLUSIVE CCGs have held up approving networks where unpopular practices have been left out of primary care networks, Pulse has learned. 

Pulse found that some CCGs have refused to sign off networks where practices who submitted applications did not welcome an unwanted practice - described previously by the RCGP chair as 'pariah' practices.

As part of the new five-year GP contract, practices will be provided with extra funding to join networks, which will see groups of practices serve between 30,000 and 50,000 patients.

While practices are not mandated to join a network, all patients must be covered - meaning patients of practices that do not join must be covered by a local network.

A GP leader, who wished to remain anonymous, told Pulse they have seen CCGs refusing to sign off networks in several areas across the country, with their own practice also being forced to have an unwanted practice in their already settled network. 

They said: 'In my area, all the practices but one managed to buddy up into PCNs. The reason is that historically, no one has trusted this practice and the GP is not particularly likeable. Quite predictably, nobody wants them to join. It’s a trust issue, not so much that we all get on and we don’t want someone to destabilise after 30-40 years of working together, and practices have established a reputation with each other.

'What the CCG are threatening us with is until we take in the practice none of the PCNs in the area is going to be signed off. So they’re putting pressure on our PCN by telling the other PCNs “we won’t sign off your PCN until this other PCN takes this practice”.

Consultant Scott McKenzie, who advises GPs on mergers, forming federations and networks, told Pulse he has received questions from practices who are being forced by their CCG to include practices they do not get along with in their agreed networks.

He said: 'There’s one practice that wants to be part of a network and that hasn’t been invited by any of the existing networks to become part of. The CCG has basically let everybody know that until such things [are resolved] they won’t be signing off any of the networks.

'The CCG has required to have a 100% coverage so the likely outcome is that they will select a network that has the most sensible geography, or maybe a smaller network, that the practice could be allocated to.

'The practices have got a history of working together and this practice, potentially, hasn’t particularly engaged or been part of these working relationships.'

According to official documents, CCGs and LMCs have until the end of June to work together and resolve any outstanding issues to guaranty full population coverage in their area.

An NHS England spokesperson said: 'We have seen a huge amount of co-operation between CCGs, LMCs and general practices, with many people stepping up to make sure PCNs happen, and we are on track to achieve full national coverage by 1 July.

'It is important that all those involved are confident that any local arrangements work for the practices and, most importantly, can deliver improved services for patients.'

Other areas have also been faced with difficulties in having their networks approved. GP Survival chair Dr Nicholas Grundy said his STP refused to sign off his network over difficulties in splitting a practice over two networks.

He said: 'At the moment, Richmond hasn’t been signed off because there’s this question mark over two of the networks.

'There’s a single set of partners with one GMS contract under two sites in different places in which there are two networks. What the CCG has said is because it’s bureaucratically difficult to split that single GMS contract into two they therefore don’t want to do that.'

The news comes after RCGP chair Helen Stokes-Lampard previously said that pariah practices would still have to be part of primary care networks, as their patients 'deserve care'.

Pulse previously reported that CCGs in some areas of England had been trying to 'manipulate' the formation of networks to align with their plans, according to GP leaders. 

It also emerged that some practices have 'hurriedly' designed their networks in light of the looming deadline

Readers' comments (5)

  • The funny bit is that 'pariah practices' are those that haven't been given a single penny of funding while others in the localities have all received funding. You keep 'missing them out' in all sorts of consultations and incentives whether it be 106 monies, funding for premises or even incentives to join PCN. What then happens is you get another 'pariah practice'- It's your own (un)doing to deal with it!

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  • And Stoking Lampard can insist that they 'have to be' part of PCNs but the law says this is an enhanced service and if they do not wish to, they just don't get the money which goes to the PCN so service can be provided by somebody else. Or is it that the money is peanuts so the PCNs consider they would be nuts to pick the pennies.

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  • This suggests that the sign up to PCNs is compulsory, which was not my understanding. However, I believe those not signed up will receive less and less direct funding. Doomed if you do sign up and doomed if you don’t in my opinion.

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  • Sounds like a plan; as long as you have a parish practice in your area then nobody has to sign up for this nonsense.

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  • if every one failed to sign up for it then they would have to re think it all - its an informal protest strike action opportunity, if we all fail to sign up and demand the money is put directly into the global sum with no strings attached - which is what we want - why not go for it - not as if you will get all the money anyway and if it all goes to pot the network is left to cover all the OOH work rather than some one else - your crazy to sign up for it in the first place.

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