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Independents' Day

PCNs and more LMCs urge practices to withdraw from network contract

All primary care networks (PCNs) in the Guildford and Waverley region have advised practices not to sign the network DES contract as it stands due to the 'overwhelming clinical and financial burdens' it will create for GPs.

In a joint statement issued in the past few days (see attached, left), the clinical directors of the four Guildford and Waverley PCNs - North Guildford, Guildford East, East Waverley and West of Waverley - said NHS England's new proposals for service specifications under the contract would degrade general practice. 

They called on all member practices to 'withdraw from the PCN DES entirely' - unless the specifications undergo 'significant alteration'.

Meanwhile, Birmingham LMC told Pulse it is advising GPs in the region that the specifications are 'totally undeliverable' and that the only way to get the proposals amended is for practices to threaten to withdraw from the network contract DES entirely.

Similarly, Lincolnshire LMC said that 'unless there are significant changes to the draft specification then practices should withdraw from the DES'.

Grassroots campaign group GP Survival has also launched a petition against the draft specifications, demanding NHS England amend its 'incoherent, inconsistent' proposals.

This comes after it was revealed the proposals have already led to some GPs resigning from their roles as clinical directors of networks.

At the end of December, NHS England released detailed proposals for five of the seven service specifications PCNs will be required to deliver from April, with a deadline for feedback of 15 January.

The proposals included the requirement for GPs in networks to carry out 'at least' fortnightly care home visits from September.

The four clinical directors of Guildford and Waverley argued the services as they stand overlook ongoing issues such as increased workload and workforce shortage, ultimately threatening the provision of GP services. 

In a statement, they said: 'There is no question in our minds that the [main services] are all structured in such a manner that the subsequent overwhelming clinical and financial burdens will dramatically destabilise primary care, increase the burnout of GPs and reduce retention and erode core provision of primary care to our populations.

'This is unacceptable and we cannot support them in their current format.'

The statement added: 'Should the draft 2020 DES specifications be ratified without significant alteration, which we believe means allowing PCNs to locally identify care needs and work with their [integrated care provider] partners to produce fully costed and staffed solutions, we could not support their implementation.

'In those circumstances the Guildford and Waverley PCN clinical directors would be forced to advise their member practices to withdraw from the PCN DES entirely.'

Birmingham LMC secretary Dr Bob Morley told Pulse the committee has reminded practices that being a member of a network is voluntary.

He said: 'Our view is that we believe that the only way that the required changes will be made by NHS England is if practices signal en masse their intention to withdraw from the DES.

'We do not believe that the usual processes of negotiation by the GPC will resolve this catastrophic state of affairs.'

GP Survival has labelled the service specification proposals as an 'incoherent, inconsistent grab-bag of ideas' that range from 'the laudable-but-impossible to the possible-but-pointless'.

It is urging GPs to sign its petition calling for the proposals to be revised.  

NHS England said it is listening to GPs' concerns, adding that the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.

An NHS England spokesperson said: 'The service specifications are being consulted on as it was agreed they would be, in line with the already agreed multi-year GP contract, and the significant funding increases which accompany it.'

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.

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Readers' comments (5)

  • The latest missive from Nigel Watson (Wessex LMC) says 'The LMC is very supportive of PCNs...' and 'all GPs would support the 5 service specifications' but 'In their current format we do not think that these are supportive of General Practice'.

    PCNs are for trying to help secondary care by keeping patients out of hospital. Thats the easiest way in which their 'success' can be measured. From the government's point of view, in the great NHS scheme of things, General Practice is expendable.

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  • Totally bonkers DES !
    Good on you guys pulling out, as this is the only option we have and the only language 'they' understand.
    We've seen loads of rubbish contract changes over the years, but this just tops it all.
    We live and work on planet NHS, not sure, what planet 'they' live on...

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  • Vinci Ho

    Interesting phenomenon
    No doubt the ice ball is gaining momentum and getting bigger . I have yet to meet any colleague saying ‘great ’ about this draft .
    Watched 1917 in the weekend , absolutely brilliant Oscar-potential-winner . Well , if this draft goes through , GP-land will become the ‘no man’s land’ between the infamous trench lines in World War One . 😈👿

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  • There is a trend for doctors who are not able to do full time work to go into positions telling others what to do and making impossible rules for those working.
    I am sure the PCN objectives are made by someone who is very part time and is totally clueless about full time general practice.
    By tradition, the king leads. We should only follow and allow people who work full time to make these rules as it will also affect them so they are not immune to any silly rules they make. Rules should not be made by GPs who are out of touch.

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  • PCNS will only work if PCNs decide on the PCNs objectives. It is obvious that CCGs and their puppet masters see the PCNS solving all the ills of the NHS with very little appropriate investment.

    PCNS will keep nursing homes safe, keep patients out of acute trusts, step patients down, employ staff at risk to thinly plaster over the widening cracks of the NHS.

    It will not be long before a PCN chair will be in front of the courts explaining why their PCN failed to keep patients safe in nursing home.

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