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80% of partners say they would reject signing network DES if proposals go ahead

The vast majority of GP partners say they would want to pull out of the network DES contract if NHS England's proposals for the service specifications remain unchanged, a Pulse survey has revealed.

Just over 80% of the 477 partners taking part in the survey said they would personally decie against signing the DES contract for primary care networks (PCNs) this year as it stands.

Meanwhile, seven in 10 partners believe it will be 'impossible' to deliver the service specification requirements - and 27% said it would be 'difficult' to provide the services.

Partners said the plans fail to take into account the pressures on primary care and the recruitment crisis facing practices.

The RCGP reiterated its concerns over the proposals and the speed at which they are being introduced - saying it would be 'almost impossible' to deliver them.

GP leaders called again for NHS England to drastically revise its plans. 

Pulse asked GP partners whether they would sign the network contract for 2020/21 if it goes ahead with the current version of the five service specifications.

The results showed over four in five GPs (82%) will refuse to sign the contract. When asked how easy it will be to deliver the specifications, 70% of respondents said it will be 'impossible'.

One GP partner commented: 'We cannot sign up to something so onerous which will be impossible to deliver without having significant impact on our ability to deliver care to the majority of our patients.'

Another respondent said: 'The DES is completely unmanageable in primary care with the specifications as currently set up. It seems they have been written with no understanding of the pressures on primary care, recruitment, staff retention or the impact the new healthcare professionals in place are actually having in primary care.'

Commenting on the survey results, RCGP chair Professor Martin Marshall said: 'There are high expectations of the PCNs and the service specifications that have been put out for consultation are certainly ambitious. However, we are very concerned that the amount of extra work required to meet these specifications, combined with the short timescales, make delivery almost impossible.

'PCNs need breathing space to recruit for new roles and build a team that can meet the challenge of current workload pressures. Asking too much of GPs who are already stretched beyond their limits is a recipe for disaster and will set PCNs up to fail.'

Lancashire and Cumbria LMCs chief executive Peter Higgins said: 'We want to make a very strong case for pushing back these unreasonable and unrealistic demands.

'We need to protect and support the development of PCNs to a realistic and achievable timescale and set of objectives. Otherwise there is a danger that practices and PCN clinical directors will walk away.'

BMA GP Committee chair Dr Richard Vautrey reiterated the organisation would be taking forward GP concerns in its talks with NHS England.

He said: 'GPs and their teams continue to operate under a huge amount of pressure, and we’re well aware of the concerns raised by the profession in recent weeks about these draft specifications.

'We’re now negotiating with NHS England on these issues, and while discussions are confidential, rest assured we are listening to doctors on the ground and using their feedback as the basis of these talks.'

At the end of December, NHS England released detailed proposals for five of the seven service specifications primary care networks (PCNs) will be required to deliver from April, with a deadline for feedback of 15 January.

The plans revealed GPs will have to carry out visits to care home patients ‘at least’ every fortnight from this September, as well as conduct structured medication reviews to all ‘identified’ patients who would most likely benefit from the service.

This led to concerns about how the plans will affect practices’ 'viability', with PCNs and LMCs advising practices not to sign this year’s network contract.

NHS England has said it is listening to GPs' concerns, adding that the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.

Meanwhile, an increasing number of GPs are resigning as clinical directors of PCN over the inability to recruit additional clinical staff for networks, and the lack of extra funding to carry out the increased work stemming from the network DES specifications.

Pulse is asking GP partners to complete our own short survey on the network contract DES proposals - with participants being in with the chance of winning £100 of John Lewis vouchers.

Related images

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Readers' comments (16)

  • Would be interesting to hear from the 20% who wish to sign.

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  • Bob Hodges

    My response to the draft proposals included the phrase 'over my dead body'.

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  • Why Not 100% , unfortunately always the problem there are those that will sign up to anything so as not to lose the money associated.

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  • Why don't the 20% work together in a PCN to prove if the plans are viable and possible to maintain a good income.
    If they are then the rest of us can join in later!!

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  • Who are the 20% and what meds are they on!?

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  • I think we’re missing the point here. The point being made is that the new DES is not adequate resourced, hence PCNs can’t deliver it.
    The fact is, regardless of funding, its undeliverable. No amount of money will find 5 clinical leads, or get me to take on OOH care for nursing homes and subscribe to the metrics. We should all vote for the whole concept of PCNs to be disbanded, and resources allocated for core funding.

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  • It will only take 10-20% of practices withdrawing to scupper PCNs because the remaining practices have to cover their work - Extended Access, Care Home reviews etc etc. Once a few pull out others will follow and PCNs will tumble like a house of cards. Expect NHSE to make major concessions in the next iteration to try and keep practices on board.

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  • I don't think they will be willing to make the concessions needed. Even fully funding the additional roles is not enough as these staff (if you can find them) cant actually do the work needed of them e.g. medication reviews (need prescribers), resus/care planning decision making etc. always seems to be deflected to GPs.

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  • good. hope they do. terrible ill thought out contract.

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  • Where is Nikita Kanani in all this? Is she still trumpeting what a great scheme this is.... glad to see my colleagues are more astute....

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