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Gold, incentives and meh

LMCs call for GPC to reject PCN model in favour of new GP contract

GP leaders in England have called for the BMA’s GP Committee to reject the establishment of primary care networks and instead develop a new contract.

LMC members will vote on a motion at the England LMCs conference on 22 November, on whether to instruct the GPC to develop a new contract that will ‘positively support the current model of English general practice’. 

The motion will put forward that PCNs as a model will not result in a reduction in workload, nor assist practices in supporting increasing numbers of patients with complex health needs. 

Put forward by Hillingdon LMCs, the motion has called for GPs to recognise: ‘That conference, with regard to PCNs, has no faith that they will result in a reduction in GP workload.

‘Is concerned that they do not actually address the issue of the dwindling GP workforce.’

If the rejection of the model is carried, then representatives will also vote on another statement to ‘guide the GPC executive team’s future strategy’.

The further statement will ask representatives how happy they are with the development of PCNs, ranging from completely happy to completely disbanding the PCN model.

It follows reports that only 15% of GPs would have approved the five-year GP contract if it was put to ballot, according to a BMA survey.

Motion in full

HILLINGDON: That conference, with regard to PCNs:

i. has no faith that they will result in a reduction in GP workload

ii. is concerned that they do not actually address the issue of the dwindling GP workforce

iii. has not seen any evidence that they will assist practices in supporting increasing numbers of patients with increasingly complex health needs

iv. believes they are the building blocks towards integrated care systems which will be to the detriment of local personal patient care

v. requires GPC England to reject this model in favour of developing a new GP contract that actually positively supports the current model of English general practice.

 

Further statement: 

If part (v) of motion 19 is carried, then the following statement will be voted on by the representatives using a 1-6 button vote. This is to guide the GPC England executive team’s future strategy. No requests to speak for or against this statement will be considered by the Chair.

1. I am completely happy with the development of PCNs as a means to sustain general practice.

2. I am happy with the development of PCNs but would also like other ways of sustaining general practice to be explored.

3. I am content with the development of PCNs but feel that other options should also be actively pursued to sustain general practice.

4. I am not happy with PCNs but feel too much work has been committed to these to change the direction of travel.

5. I am not happy with PCNs and would like to see a pause in developments in order to evaluate their efficacy in sustaining general practice.

6. I would like to see PCNs completely disbanded and a new GP contract negotiated for 2020/21 as a matter of priority.

Readers' comments (12)

  • too late mate. even if you go on strike now the government will just remove funding, then surgeries collapse, get taken over by private companies or hospital trusts. there will be no new contracts, no new funding. there is no incentive for this at any government level and they really don't care who does the work as long as its cheap. we lost the boat years ago when GPs failed to fully support the strike about pensions. Its all about holding on till you either retire, move abroad or accept salaried work or leave and go private like the dentists. The BMA and RCGP are ineffective. not sure why you even bother with them at all. they have done nothing over the past 11 years apart from whine from a distance and wring their hands begging for more. plus they endorsed the PCN contracts even though it was obvious they were a huge mistake and woefully underfunded - that's why we didn't get a ballot because they and the government knew we would say no. total and utter farce.

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  • PCN = P retty C rap N ews

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  • I think PCNs are shaping up to be a disaster, in terms of workload and finance, but suspect that if they go down the toilet then those who have worked towards them may not get the gongs they hope for.

    Lest we forget, GPC have form for disregarding the expressed will of conference.

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  • Once PCNs go, all the "extra staff" will be a problem.

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  • We should've noticed that the acronym for the PCN DES' Additional Roles Reimbursement Scheme is ARRS.

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  • Bit late methinks... When the PCN proposal was launched, we raised our multiple concerns with our local LMC highlighting various contractual shortcomings that we were concerned about and the fact that we were being pressurised to join. The response was that of enthusiastic endorsement for PCN's as the way to 'save' General practice. We decided not to sign up despite this endorsement and remain convinced that this was the correct decision for us.

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  • GPs need to wake up first. The biggest contract change since 1948. No debate , no vote , How is this acceptable.

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  • @d in vadar : "Its all about holding on till you either retire, move abroad or accept salaried work or leave and go private like the dentists"

    I agree 100%. There is much more of a resigned, transactional relationship with patients at the frontline now: they don't care how it is funded or owned. "I just need an(y) appointment" and in my experience they don't even notice whether it is "my own Drs" (seems to be in name only nowadays..!) a drop in, extended hours, OOH service or a managed care organisation like a PCN.
    I think we overstate our model sometimes. Very few patients have had a close, longterm relationship with a particular GP for years. The elderly miss it, but it will never come back now. End of.
    Too late.
    Unless the staffing levels are sorted and clinicians have a chance to influence care delivery, it will all deteriorate further and we Brits are too pathetic to speak up.

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  • DrRubbishBin

    Patients don't care who they see because many of them don't know any different, unless they have experienced health care in a different country. i used to feel offended when patients from eastern Europe told me 'it wouldn't be like this at home' now i just nod my head and agree. 'yes' i say 'it is indeed crap' . Add to that the angry 20 something who's come in to complain they're no better after taking the antibiotics they were given for a 'presumed uti' via their video Dr. Where do you start? ' i think video consultations are a bad idea' , 'video consultations are a business idea not a medical one' - you need like an hour just to explain and you've only got 10 minutes to sort out the mess. 'yes it's shit isn't it ' is really all there is you can realistically say in the time available

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  • Londonwide LMCs said on 7 May :
    We have produced a new series of guidance about the PCN DES entitled: "Keep It Simple". Practices are receiving varied and often contradictory advice on what details need to be supplied on the PCN DES form. Our guidance provides clear and concise clarity
    And it showed its full collaboration in its link:
    https://www.lmc.org.uk/visageimages/GP%20Contract%202019/02.05.19%20PCNs.pdf
    which includes:
    * The Primary CareNetwork Contract DES
    * Establishment of a Primary Care Network
    * Collaboration
    * Coordination
    * PCN list size
    * PCN patients
    * Role of Federations
    * PCN area
    * Appointment of a PCN Clinical Director
    * PCN Support

    Not a single word of disapproval or any trace of qualms
    Londonwide LMCs might consider letting us know their current position on PCNs

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