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A faulty production line

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.'

Related images

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Readers' comments (30)

  • I honestly thought today was April 1st and not July 1st.
    In any case, DHSC and NHSE had always known the game plan with this PCN idea. The idea has just been voiced out for others to hear. Either the BMA was blindsided or our 'top doctors' could just not care less about sacrificing us to get their gongs.
    As already mentioned, less doctors are going the partnership route and with the older ones retiring, partnership model will ebb away. Just hoping we will understand our worth and not break ranks when we become salaried.....even the worst solicitor knows well enough not to undersell his services.

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  • hospitals are the problem; voracious appetite for resources. Everything else is small print

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  • |KeepThe RedFlagFlying | Locum GP|01 Jul 2019 1:53pm

    It's all part of the "game plan" to privatise the NHS, and turn it from a "health care provider" to a "source of profit" for the rich "elite".

    - At least then, there would be competition to drive quality and affordability. As opposed to now, when it makes poorly qualified public sector officials financially and AUTHORITATIVELY rich.
    You clearly are guilty of a common problem amongst the socialists... You have no love for the poor, you simply hate the rich entrepreneur. Your politics are the politics of division (rich vs poor), whilst those of us on the Right are pointing out to everyone that what's best for the poor, is for the economy to be as free as possible with a small state.

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  • please-delete-this-fucking-profile-i-cant-delete-it-in-my-account-settings

    This comment has been removed

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  • Is this some honesty coming out of NHSE ? Looks like the conspiracy theorists are right.

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  • The only place where the ties are more expensive than the stethoscopes and no-one looks tired.

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  • Bring it on. Chambers for the brave, Salaried drudgery for the meek. Either way, costs will go up and productivity will go down. We have already seen this since 2004 when the motivation to "get it all done before we go to bed" changed into "ask them to call back at 6-30pm" I've done both.
    ..and still, no-one seems to understand the way we hold it all together when every one else walks away (secondary care, Social Services, Paramedics).
    ..what interesting times.

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  • salaried aint that good either - heading back to FT locum - or part time in reality cause earn more for less hours. its goodbye general practice and hello Babylon - except the fate of Babylonia wasn't that great either - history repeats itself

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  • If our practice hands back the DES (PCN are a DES) I will be salaried to no one. This sounds like DoH revealing how little is understands GPC and GMS?

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  • The options will be either 1) privatisation 2) retrain back into hospital medicine 3)emigrate.

    Message to the centre. Death of partnership equals the death of General Practice in the UK and also the end of the NHS in its entirety as there is no possible mechanism by which secondary care can continue. Without primary and secondary care, community and social care will collapse. In the absence of all these things the nation state will collapse. The eastern countries have an affordable private infrastructure to fall back on which we most definitely do not.

    NHS england should not even mention this in any communication and the idea should not even raise its head. The idea should be up there with what to do if aliens land and other doomsday scenarios.

    Instead the approach I feel is wrong. The reality is that the British people have spoken and they have agreed to further austerity and reduced investment in the health service. We are from the people as well. It is not worthwhile blaming NHS England for this, or for NHS England to blame us. I appreciate their battles with the department of Health and the difficult conversations that they have with the treasury.

    Instead of playing blame games, we should switch the conversation to see how we best deploy what resources that we have to achieve the maximum health benefit to the people of the United Kingdom, whilst recognising each others pressures.

    That is definitely a conversation and thought process that GP's can get involved in.

    And message to GP's please do not be government mouthpieces. They have communication departments that do this. No other GP's I have met agree with the NhS England position and they are hurt by it. People that do agree with it, sound compromised and it makes us sceptical.

    It is not up to pcn's to convince young gp's to take on partnerships. It is up to gp partners to do this and convince us all and also to make the opportunities available.

    - anonymous salaried!

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