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GPs go forth

1 in 10 clinical directors plans to resign from networks in next 12 months

Over 1 in 10 (11%) clinical directors of primary care networks plan to quit their PCN role in the next 12 months, a new BMA survey has revealed.

The survey of clinical directors, which took place ahead of the release of new controversial network specifications, also revealed around a quarter (27%) said PCNs had had a 'negative' impact on their member practices' workload.

Although 63% reported it was too early to determine whether networks have affected practices’ workload positively or negatively.

Almost half (49%) of the respondents classed their overall workload in general practice as 'unmanageable', according to the survey of 213 clinical directors - around a fifth of the total number across England. 

Meanwhile, 71% said they were not confident PCNs would be able to improve the capacity of the GP workforce and address staff shortages - one of the key arguments put forward for the creation of networks by policy officials.

Recruitment problems have also led to 'low levels of reimbursement' for the additional clinical roles NHS England is funding networks to hire, according to the BMA report on the survey.

Almost a third of clinical directors (26%) indicated that their PCN was not receiving reimbursement for these additional roles yet - social prescribers and clinical pharmacists - which the BMA said it believed was due to 'limited availability of sufficiently trained or qualified candidates'.

BMA GP Committee chair Dr Richard Vautrey said the survey shows PCNs 'cannot be expected to solve all problems facing the profession' - and stressed the need to listen to GPs' concerns about the proposed service specifications.

The survey also revealed clinical directors are experiencing varying levels of workload, depending on the size of the network they manage.

Almost two-thirds of clinical directors (63%) who lead PCNs of under 40,000 patients find the workload unmanageable, compared with 42% working in large PCNs - of over 60,000 patients.

One clinical director said: 'I feel the network DES favoured practices that were already federated [or] merged. It has left smaller, independent practices at a significant disadvantage.'

Other findings from the survey show:

  • Over half (53%) of clinical directors say their relationship with their ICSs, STPs, and local trusts are poor;
  • 58% said they were 'not confident' PCNs would ensure the success of the GP partnership model
  • Almost 40% of participants said adequate funding should be a priority in what PCNs need to succeed.

Dr Vautrey added: ‘It’s clear that PCNs cannot be expected to solve all problems facing the profession and the wider NHS – especially if concerns around present levels of workload are not heeded.

‘This is especially relevant with regard to feedback around the recently-published draft service specifications from NHS England and NHS Improvement, with clinical directors right across the country expressing their grave concern about the impossibility of delivering what has been specified, even with the planned workforce expansion.'

He added: ‘Less than a year after they were introduced as part of the GP contract, it is a crucial time in the development of PCNs and it is vital they are given adequate funding and practical support – and that any goals are fair and realistic – if they are to deliver on their potential.’

The recent publication of the draft network specifications has raised concern amongst many GPs in the profession, leading to multiple LMCs advising practices not to sign the network DES contract as it stands.

A Pulse survey recently revealed 80% of GP partners will pull out of the network DES contract if proposals go ahead.

Readers' comments (4)

  • Vinci Ho

    I am in that 1 in 10. But who am I ? Only an ordinary grass-root GP?
    "It's a shame she won't live - but then again, who does?"
    Blade Runner

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  • Took Early Retirement

    There will be plenty who will want to take their places if it means less time doing the really stressful stuff of seeing punters. (Not that all admin type doctors do; just most.)

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  • I have resigned. Original DES costing is pretty marginal funding. £1.76 practice re-imbursement will eventually only cover 30% conntribution to PCN staff. No funding for any admin support to CD. No funding for mentoring PCN staff. Unrealistic expectations in "long term" health plan that has been copied and pasted into DES for next year. Unmanageable reponsibilty on shoulders of CD while trying to be full time partner and responsibilities to practice.
    "Bonkers" was how one GP described the original DES and I must agree. Funding needs to be to practices not PCNs with a gentle move to collabarative working - not the other way around. BMA rep said they wanted to protect smaller practices however PCN DES does not because smaller practices cannot make the staff adjustments to fund the 30% contribution. BMA please listen. Negotiate to fund practices. This was a national contract change and we did not get to vote on its introduction. Shameful

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  • NHS ENGLAND are under pressure-they need to pull a rabbit out of the bag-a miracle-but without spending any money to keep Johnson happy.
    So we get a kicking.
    They can't change, they won't change.
    The answer---we all say no, goodbye, adios

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