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Independents' Day

Practices 'hurriedly' trying to meet network deadline

A number of practices across the country have 'hurriedly' designed their networks, which might later create 'contentious issues', GP leaders have warned. 

Some practices are also yet to submit their application to join a primary care network - just one day before the deadline - Pulse has learnt. As of 14 May, 12 CCGs had confirmed to Pulse that they had not received any network applications so far.

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 30,0000 and 50,000 patients based on geography.

All networks are required to submit registration information to their CCG by 15 May 2019. CCGs will then have until 31 May to confirm registration requirements and approve variation to GMS, PMS and APMS contracts for all networks.

GP leaders reported that tight deadlines have prompted practices to rush to submit their plans while some have faced difficulties in trying to work collaboratively with neighbouring practices. 

Sandwell and Birmingham LMC secretary Dr Bob Morley said: 'In some areas, things seem to be going okay, but inevitably there are a number of practices who are still in discussions with their CCGs and other practices because their chosen choice of network doesn’t seem to be falling within the rules.

'Also a couple of practices are having trouble getting other practices to work with them. I think these are inevitable consequences of these changes. In an ideal world, practices would’ve had a much longer period of time to try and make all of this work.'

He added: 'From my intelligence, the majority of PCNs will hopefully be agreed and settled by 15 May but I suspect there’s going to be those that might have been made hurriedly and there are going to be a number of contentious issues that are still are going to be difficult to sort out right up until the deadline.' 

NHS England said it could not confirm how many applications have been submitted to or rejected by CCGs as the deadline has not passed yet and practices are still working with their partners to form their network.

Tower Hamlets LMC chair Dr Jackie Applebee said she was not surprised by the lack of application submissions given the tight deadlines.

She said: 'There hasn’t been time and deadlines are too short. The contract was announced end of January, which is barely three months ago. 

'People had a lot of things to reconcile and it’s only at the beginning of April that they started to have any headspace to think about forming primary care networks.' 

Echoing her comments, BMA honorary vice president Dr Kailash Chand OBE said: 'The truth is that people don’t understand the whole concept of primary care networks. They have their anxieties and fears and are concerned that this could be eventually taken over by the local authorities or the foundation trusts.

'Nobody has come and reassure them and that’s perhaps one of the main reasons for people not filling up the applications. GPs are by and large skeptical themselves.'

Pulse previously learned that CCGs in some areas of England have been trying to 'manipulate' new primary care networks to ensure they align with their own plans.

GPs told Pulse a number of CCGs have been trying to influence how networks are set up, including telling practices which GP should become their clinical director.

And this month, Pulse reported that Babylon GP at Hand is in the process of registering as its own primary care network

GP leaders have expressed concern over this move, which they say will 'disrupt the system to the point of destruction'.

Timetable for network contract DES introduction 

By 15 May: All primary care networks submit registration information to their CCG

By 31 May: CCGs confirm network coverage and approve variation to GMS, PMS and APMS contracts

Early June: NHS England and GPC England jointly work with CCGs and LMCs to resolve any issues

By 30 June: All primary care networks confirm to CCGs the network agreement has been signed by all participants before CCGs sign off all network submissions

1 Jul 2019: Network Contract DES goes live across 100% of the country

Jul 2019 to Mar 2020: National entitlements under the 2019/20 Network Contract start:

  • year 1 of the additional workforce reimbursement scheme
  • ongoing support funding for the clinical director
  • ongoing £1.50/head from CCG allocations

Apr 2020 onwards: National Network Services start under the 2020/21 Network Contract DES

Source: A five-year framework for GP contract reform to implement The NHS Long Term Plan and BMA PCN planning calendar

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Readers' comments (9)

  • Another back of the fag packet sweeping change brought in in a rush so no one can critically appraise it doomed to failure like the many shiny new red tractors before them.Collectivization continues.But the famine comes closer.

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  • Remember being told nobody HAD to join a bigger group? Now look at us, herding ourselves towards the cliff edge like proverbial lemmings.

    Never more glad to be gone. Good luck, friends.

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  • Why any GP would sign up to a contract that is open to unilateral alteration (see Clause 80)is beyond me. The increase in GP workload required for involvement in a PCN with responsibility for extra staff that I really don't desire in return for a pitifully small return that may well be swallowed up by administration costs really doesn't resemble the rhetoric that this is the great GP workload solution that is being marketed. Whilst we still have a choice, I shall exercise my right to stay well away from any PCN DES.

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  • I suspect there will be a high signing up to collect the initial joining payments but it will then peter out. Our practice is VERY tight on space 16,000 oatients in 500m2 so no room for noctors etc. Fortunately we don;t as yet need them.....

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  • There have been many reports over the years of the BMA’s continued fine abilities with contracts (having failed at just about everything else). Have they finally lost their only remaining skill?

    From above: (‘a contract that is open to unilateral alteration (see Clause 80)is beyond me.’)
    - beyond me as well - must be ‘Contract Law from a Parallel Universe’ as on this planet both parties have to mutually agree I.e. there can be no such activity as ‘unilateral alteration’ (which suggests ability for alterations against the other parties interests and without the other parties valid consent).
    Bah! Humbug!

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  • Yet another reorganisation. Definition of insanity is repeating the same thing over and over again, but expecting a different result each time.

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  • Remember PCN is a DES - you do not have to sign up for this and if you do, you can give 3 months notice to leave - hopefully, this choosing to leave will not be a process as messy as BREXIT:) However, the struggle for power is on. Some new Medical Directors are absolutely reluctant to discuss with neighbouring localities to see how they are functioning and to brainstorm. Too much of vested interests and deals going on and it's already stinking. God save the GPs.
    Kudos to the GPs in one are up North who heavily criticized the PCN concept but were voted down at the GPC meet. Being voted down actually is a good sign, it means they were right as we know that the heard mentality doesn't allow rational thinking. Do it anyway you want, as long it is their way.
    GPs have signed up 'provisionally' by the 15th but there is time to reconsider - Would really be better off with a new PCN DES if you have to contribute 30% for staff employed, will you have any control if the Bank accounts, the Medical Director and the Federation boss all sit in one Practice in a PCN - how much transparency can you expect if your PCN is not willing to discuss the way forward with neighbouring locality PCNs to share and brainstorm what it the best way forward.
    There is a burning need to tread carefully on the coals !

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  • 'herd' misspelt as 'heard'- apologies

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