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Independents' Day

LMC advises GP practices not to sign network contract

EXCLUSIVE An LMC has urged GPs not to renew their primary care network (PCN) contract DES this year after concluding the requirements threaten the financial viability of practices.

In a position statement issued today, Berkshire, Buckinghamshire and Oxfordshire LMC said it cannot endorse the PCN DES due to the 'unrealistic' requirements laid out in new draft service specifications. 

Its chief executives and co-chairs called on practices that are part of a network to pull out of the PCN contract after the LMC assessed they would face a deficit of £100,000 a year from the proposals. 

Meanwhile, Nottinghamshire LMC has suggested GP practices in the region 'will seriously question' being part of networks in light of the 'lack of insight into the challenges facing GPs' displayed in the draft specifications.

GPs have expressed major concerns over NHS England's new proposals for networks, which include the requirement for GPs to carry out fortnightly care home visits.

Practices in PCNs will have deliver seven national services from April 2020 onwards, including enhanced care in residential homes and structured medication reviews.

Berkshire, Buckinghamshire and Oxfordshire LMC carried out an analysis (attached, left) of the PCN DES draft service specifications, which were released at the end of last month, looking at aspects such as funding and the additional staff required.

It concluded that practices will face a deficit exceeding £100,000 per year, despite having access to the 22,000 extra practice staff partly funded by NHS England

The document said: 'These specifications carry an extremely high workload which would be impossible to deliver based on available workforce which exists within the health system.

'These specifications offer no benefit to practices and are completely unrealistic.' 

The LMC's chief executives acknowledged GP practices would lose out on access to network funding by withdrawing from the DES but insisted the deficit to practices posed by the specifications would be 'far greater'.

They said: 'The LMC cannot in any way endorse these specifications, nor do we have any confidence that national negotiations will result in NHS England agreeing to sufficient positive changes.

'We do not recommend practices renew the PCN DES in 2020.'

A separate statement released this week by Nottinghamshire LMC also suggests that practices question their involvement with PCNs.

It said: 'When looking through the individual specifications, there are concerns about the capacity to do the extra work and it appears that much is dependent on additional staff freeing up capacity to take up the extra services and working across providers. 

'We need the draft service specifications to change dramatically to give PCNs to oxygen to breathe and thrive.'

It continued: 'Otherwise the benefits of being members of PCNs will quickly be lost on member practices some of whom feel that the jury is very much out on whether this is the right way for general practice to go anyway.'

The statement added: 'GPs will naturally start asking themselves whether they should sign up to the PCN DES in 2020/21 if it means that their national contract is going to continue to be affected as NHS England effectively overrides what it doesn’t like in the GP contract.'

NHS England said the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.

It has previously said it is listening to GPs' concerns and stressed it is collecting feedback on its proposals until 15 January

The BMA has reassured GPs that any concerns about new network DES proposals are being heard 'loud and clear' and these will form the 'basis' of its contract negotiations with NHS England.

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.

Readers' comments (28)

  • Now that Brexit has been 'done' welcome back to Tory Britain.

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  • Nottinghamshire and BBO LMCs will not be the last LMC to make this rational advisory to their constituents. The whole schedule of draft PCN DES proposals is completely beyond the scope of the current workforce, let alone being unrealistically underfunded and under-resourced.

    Do not touch this poisoned chalice

    GPC and RCGP are you listening?

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  • The question is : was this shambolic proposal a result of incompetence, or a destructive desire to crush us? NHSE should provide an explanation!

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  • PCNs are a way of destroying general practice as we know it. I'm so glad we never joined one..

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  • Well Done BBO LMC

    The link to their document is well worth following - well-argued and truly eye-watering the work involved - I left my practice at the end of last year and am now working as a sessional doctor and this kind of rubbish makes me so relieved.

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  • Come on guys; the persons that wrote this are someone’s children! Yes, they probably have a good line in carpet slippers, cardigans, rose tinted spectacles and need a cappuccino between seeing each patient.

    Mind you it could be worse and it get imposed!

    But then again how do you impose a contract on a non-existent workforce?

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  • Vinci Ho

    First wave of nail bombs dropped . More will come ?
    In a way , refusal to sign is a form of industrial action .

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  • Finally some hope of support for our position of not signing up to this contract in the first place ... it was always unfunded, ill-conceived and totally ignored the lack of available (and shrinking) GP resources.

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  • Who could agree to this?! but then ive thought that about the GMC contract since i spent 6 months as a new partner then pulled out once i spelled the coffee before joining. The majority of sheeple will just throw themselves of the cliff and keep on moaning as we Brits tend to do.

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  • Read the BBO LMC analysis: its damning.
    It also makes a good point: why is this a *public* consultation on what is basically a specific GP T&C matter? Especially as the survey doesn't ask who you are..

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