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NHS England: PCNs must succeed or face ‘being salaried to other NHS providers’

NHS England has said the networks that come into being today will have to succeed in convincing a new generation of GPs to go into partnerships or face becoming ‘salaried to other NHS providers’. 

A paper for the NHS England board meeting last week said that the implementation of networks have given the independent contractor model a ‘major shot in the arm’.

But it added is was the responsibility of PCNs to either ‘take responsibility for securing a new generation of partners, or by default (rather than choice) become salaried to other NHS providers’. 

GP leaders said that suggesting the survival of the partnership model is now the responsibility of PCNs is a ‘false premise’ and warned about the risks of having independent contractors ‘swallowed up’ by larger providers.

The document states: ‘Looking ahead to 2023/24, our ambition is that PCNs will have done five things: (i) stabilised the GP partnership model. Through the network contract, we have given the independent contractor model a major shot in the arm.

‘It is now down to PCNs to decide their own long-term future: take responsibility for securing a new generation of partners, or by default (rather than choice) become salaried to other NHS providers.’

Other expectations for PCNs include: 

  • Help solve the capacity gap and improve skill-mix by growing the wider workforce by over 20,000 wholly additional staff;
  • Become a proven platform for further local NHS investment, including in premises;
  • Dissolve the divide between primary and community care;
  • Achieve clear quantified impact for patients and the wider NHS once completing the previous duties.

Londonwide LMCs chief executive Dr Michelle Drage said that the networks should not bear the responsibility for saving the partnership model.

She said: ‘The additional investment via the network contract provides useful support, but it is a false premise to suggest that the survival of the partnership model is now the responsibility of PCNs and their member practices.

‘There is much more that the Department of Health and Social Care can do to alleviate the bureaucratic burden on partners, reduce financial uncertainty, support struggling practices and encourage proportionate regulation. If independent contractors were to be swallowed up by larger providers, the Government would rapidly realise that it has lost a service which provides unprecedented quality of care for patients and value for money to taxpayers.’

Dr Farzana Hussain, a GP partner in Newham, said: ‘I agree with NHS England’s view and believe that PCNs will give the partnership model a chance to not only survive but also thrive. However, its important to recognize that taking responsibility for and growing a new generation of partners will require time, new skills of collaborative team  working and much effort. 

‘Making partnerships an attractive option for younger colleagues remains a challenge with the current workload issues faced in primary care and the lack of training that GP trainees have in the curriculum to enable them to be partnership ready.’

She added: ‘I remain optimistic that this is achievable but requires specific funding for training and education. The requirement to deliver increasing number of services over the next five years and embed new health professional roles in networks may be a distraction to this vital work. There should be an investment in the PCNs to release this time and grow the leaders and teachers who can fulfil this positive ambition.’