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GPs go forth

NHS England pledges to change network proposals after 'significant' GP concerns

NHS England will 'significantly' redesign the primary care network (PCN) service proposals after over 4,000 GPs voiced concerns over the networks' ability to deliver the specifications.

The network proposals, revealed in a draft document on 23 December, caused anger among the profession when it was announced that GPs would have to carry out 'at least' fortnightly care home visits from September.

GP leaders 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.

This was followed by GPs stepping down from their roles as clinical directors of networks

NHS England has now said it wants to agree a 'significantly reworked set of service specifications', with discussion set to be held at the BMA GP Committee meeting on 6 February. 

The consultation received a total of 4,048 responses between 23 December 2019 and 15 January 2020, and more than 200 'direct feedback emails'.

In its specification summary report, NHS England said the feedback unearthed 'clear concerns' including insufficient funding and the capability of PCNs to deliver the requirements with a shrunk workforce.  

The report said: 'Whilst there was a level of in-principle support for the aspirations of the individual services, the engagement showed major concerns. These include; the workforce implications and the investment general practice is being asked to make in new workforce roles; the level of resource available to support delivery; the level of specificity and length of the specifications and the aggregate effect of introducing all five services from April 2020.'

It added: 'We want to provide PCNs with certainty and renewed confidence about their future as rapidly as possible. The feedback has already been informing negotiations on the final GP contract package, which we want to agree as soon as possible with the BMA GPC, addressing the core concerns raised in a way that continues to respect the existing five year deal, sustains general practice, and secures improvements for our communities.

'The scale and feedback received demands a clear response, in the form of an updated overall contract package, as part of which we want to agree a significantly reworked set of service specifications.'

In a tweet, Berkshire, Buckinghamshire and Oxfordshire LMC chief executive Dr Richard Wood warned NHS England that this might be 'the last time GPs can pull out of the DES relatively unscathed'.

He said: 'Does the new spec represent a more realistic long-term goal for PCNs, or have you just adjusted for the short-term? As LMC CEO I need to advise my practices with the long view in mind.'

In response, NHS England director of primary care Dr Nikita Kanani said: 'Thanks for asking. Of course (some would say) this is a fundamentally different way of working now. Better. More empowering. Realistic and hopeful. GPC will have to decide but I am naturally hopeful.'

The BMA will negotiate and agree on the proposals with NHS England on 6 February.

Readers' comments (36)

  • Believe it when I see it!! NHS England are a bunch of clowns with little or no purpose, no obvious ability following political diktat in the search for favour at the tax payers expense.

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  • Absolutely Dermot, a pledge means SFA till its delivered.

    Politicians full of them at election time!

    As we are going to be busy dealing with the now arrived Coronavirus (BBC news) can we just park negotiations for a year?

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  • I pledged to give up saying 'crap' every time I see headlines like this; so far I guess I'm about as successful as NHS England are

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  • The long view is one of managed care: metric-driven and process-led. 'Empowerment' doesn't figure.

    NHSE will do the least revision necessary to get GPs to sign up, but it's already clear what's to come once on board.

    Is PCN DES what GPs need to rescue/restore/support general practice? Sorry but, no.

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  • Should shelve it completely and let us at least have a year of NO CHANGE

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  • Cobblers

    NHSE method is a standard negotiation tactic. Go in with an extreme but "credible" position allow oppositional screams to peak and die down then give a little, maybe a little more, and get what you wanted in the first place.

    NHSE needs to face a blank wall. There is no more give in this NHS elastic.

    A fundamental rethink is needed in terms of NHS provision.

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  • Do you want to hear about PCNs, transformation and collaboration in general practice, patients and access, providing accessible primary healthcare, data sharing agreements, STPs and ICPs and much more?

    Join over 300 fellow GPs, practice managers and other key team members at Londonwide LMCs’ free to attend 2020 Annual Conference 'Let's Stick Together' on Tuesday 10 March 2020.

    The all day event will be chaired by Dr Zoe Williams, GP and broadcaster. The latest speakers to join the exciting line up include:
    Dr Michelle Drage, CEO, Londonwide LMCs
    Professor Martin Marshall, Chair, Royal College of General Practitioners
    Dr Clare Gerada, Clinical Chair, NHS Assembly
    Dr Tom Coffey, Health Advisor, London Mayor
    Sir David Sloman, London Regional Director, NHS England and Improvement
    Dr Henrietta Hughes, National Guardian for the NHS, National Guardian's Office
    Lord Victor Adebowale, Chief Executive, Turning Point
    Dr Lisa Harrod-Rothwell, Deputy CEO, Londonwide LMCs

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  • This is a ‘tactical withdrawal’ (like the ‘Battle of Hastings’). It’s pretend to be weakening, then suck the naive in and slaughter them.

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  • Agree with Decorum. Tactics, tactics. Wheel out Plan B after “listening”, when in fact this was the aim all along. Present as a victory and the usual suspects will fall in line given their pathological need to comply and be seen reasonable. We forget these changes are incremental. What will be on offer in 2025? 2030? It’s line in the sand time. Half screwed is still screwed.

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  • Agree with above. It is a con. Scrap it. We are already maxed out.

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