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A faulty production line

Hancock wants ‘value for money’ from PCNs in GP contract negotiations

The health secretary has said he wants to ensure ‘value for money’ from primary care networks (PCNs) as part of the ongoing contract negotiations with the BMA.

In a House of Commons session this morning, health secretary Matt Hancock also stressed PCNs have been an ‘incredibly successful innovation’.

GP leaders said that PCNs were meant to provide stability, not to put extra pressure on practices.

During the sitting, in which questions are put to the health secretary, Labour's shadow health secretary, Jonathan Ashworth, asked Mr Hancock how he was going to 'fix' the GP contract negotiations.

Mr Ashworth added: 'Or is he [Mr Hancock] content to see more GPs walk out of PCNs before they’ve even got off the ground?'

Responding, Mr Hancock said: 'He’ll [Mr Ashworth] understand why I want to get the best possible value for money, for the money that the NHS spends.’

He added that negotiations with the BMA over the GP contract are ‘always tough’ but that PCNs have been successful so far.

He said: 'Primary care networks have been an incredibly successful innovation, with the whole country covered by PCNs, which allow practices to work together.'

The exchange between Mr Hancock and Mr Ashworth follows the release of controversial network proposals by NHS England, which have caused an outcry among the profession and are now being discussed as part of contract negotiations.

GP leaders warned the proposals, covering five service specifications - one of which included the requirement for GPs in networks to visit care home patients every fortnight - could threaten practices' viability.

They warned the plans were not achievable due to the increase in workload and lack of additional funding during a time of a staffing crisis in general practice - and in some regions practices were advised to reject the network DES contract altogether.

GPs have also stepped down from their roles as clinical directors of networks following the release of the proposals.

Medical secretary of Lincolnshire LMCs Dr Kieran Sharrock told Pulse that he believes PCNs ‘will not be in existence in a few months’ if this is the Government’s attitude.

He said: ‘PCNs were first designed to provide stability and resilience to primary care because of the unprecedented workforce and workload issues that we’re suffering, but all they’re doing is putting extra pressure on practices and groups of practices. With rhetoric like Matt Hancock’s, I think you’ll find that practices disengage.’

He added that while it is ‘completely correct’ to ensure that tax-payers’ money is used wisely, the proposed PCN specifications would fail to deliver on their aims because they places ‘too much extra work’ on practice teams.

He said: ‘The funding should really be there to provide resilience and support for practices and PCNs to provide essential services and help prevent patients from being unwell, whereas what they were doing was going to stretch practices too far.

‘All they were going to achieve was the collapse of general practice as we know it.’

Lancashire and Cumbria LMCs chief executive Peter Higgins reacted to the health secretary’s comments with 'despair’ because any suggestion that PCNs ‘aren’t already going the extra mile is naïve and insulting.’

He said: ‘Even if PCNs wanted to do all that’s expected of them, they couldn’t because they haven’t got the infrastructure support, the time and the management support, let alone all these extra staff and additional roles they’re supposed to have.

‘I would support PCNs unreservedly but they’ve got to have time to mature and develop without being micro-managed to incredibly detailed performance targets. The level of detail is almost like telling a consultant how many stitches to put in an appendicectomy.’

Mr Higgins added that it feels as if GPs and PCNs are being asked ‘to justify every ha’penny and penny that’s spent on them’.

He said: ‘It’s that micro-managing and distrust that I find disappointing.’

 

Readers' comments (54)

  • Define delusion- 'an idiosyncratic belief or impression maintained despite being contradicted by reality or rational argument'

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  • Delusional was the first thing that came to my mind as well.

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  • They've already been successful?

    At what?

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  • Not this time Mr Hancock. Not this time.
    I will not be signing up for unsustainable work and a 30% pay cut for the privilege.
    Unfortunately you can't bluff your hand anymore.

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  • @JAM GP
    Of course they haven't been successful at anything.
    But Hancock and pals will just keep repeating the lie until its true, aided and abetted by their chums who own the media.
    Bevan was right. We are dealing with vermin.

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  • PCNs have achieved nothing so far other than frankly wasting a lot of people’s time, which could have been far better spent on virtually anything else. The concept is dead as far as many GPs are concerned including me. Personally I would not consider routine GP care home reviews as good value for money or good use of a finite workforce

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  • Unfortunately for Matty there is nothing else for the golden goose to lay! The politicians and their allies- NHSE, media, and worse of all elements of BMA, RCGP have managed to destroy the most effective, cost efficient part of the Health Service. Whatever they will be left with will be infinitely poorer than what they could have had with proper support. At least Hunt will be happy we have done our penance! Even the most pro NHS elements of the BMA must now acknowledge we are being set up to fail, the end game is well and truely underway, we shall probably be held up as the villains but the real culprits are the various elements mentioned above but add in the GMC, legal profession and the small but not insignificant percentage of the population which have totally abused the staff and service over the years. Cannot see any way out of this one folks but as a wise sage mentions "They need us more than we need them."

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  • Like you aren't getting incredible value for money from what remains of General Practice Mr Hancock? The time is approaching to revert to core services only. PCN's - haven't and wouldn't touch them with a bargepole.

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  • totally agree with you matt, if will be value for money once you quadruple the funding involved and remove the 30% practice tax, when is the cheque arriving?

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  • Government so keen on value for money
    they have had the value for years now it is time to pay the money
    Please don't be fooled again 1 unit of money for two units of work is a rotten deal

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