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The waiting game

RCGP urges NHS England to restart development of PCN specifications

The RCGP has recommended NHS England to 'begin the process again' of drawing up service specifications for primary care networks (PCNs).

In a letter issued today to NHS England chief executive Simon Stevens, RCGP chair Professor Martin Marshall again highlighted concerns over the controversial PCN service specifications. 

He emphasised that while the college supports the establishment of PCNs and 'believe they represent a real opportunity to do things differently', it is 'deeply concerned' that the rapid process of consultation and implementation of the five service specifications has been counterproductive. 

The five specifications that will be introduced from April onwards include a service to ensure 'enhanced care' in residential homes - which requires GPs to visit residents every two weeks. They also cover structured medication reviews, anticipatory care, personalised care, and early cancer diagnosis services.

Professor Marshall described the current specifications as 'overly prescriptive', and stressed that members have raised concerns that they would place 'significant pressure' on networks before overstretched practices begin to feel the benefits of additional staff and funding.

He acknowledged that last month’s snap general election and the timetable for negotiating the GP contract placed pressure on the amount of time available for consultation, but stressed this hasn’t allowed sufficient opportunity for frontline GPs to respond.

NHS England released the draft proposals on 23 December and its consultation on the plans closes today.

Professor Marshall warned in the letter that PCNs will 'fail' if they are overloaded with work too early on.

The letter continued: 'If adopted in their current form, the specifications will inevitably impact on practices' ability to maintain the accessibility and services they are currently providing and take away the freedom for professionals to truly improve care for their patients. 

'This is particularly acute for places that are finding it challenging to recruit to the new PCN roles and for areas with significant deprivation that are already managing excessive workloads.'

In the RCGP's official response to the consultation, Dr Jonathan Leach and Dr Victoria Tzortziou-Brown, joint honourary secretaries of the RCGP Council, also stressed that 'practices are still working to deliver routine services in a time of unprecedented demand'.

An NHS England spokesperson said: 'Patients are keen to see further improvements in their highly valued local GP services, and taxpayers are backing these with extra funding in line with the contract GPs agreed in January 2019.

'Discussions on the phasing of these improvements are well under way with a view to agreeing the final contract for 2020/21.'

In the past week it has emerged PCN clinical directors have already resigned from their roles over the proposals

Meanwhile, a Pulse survey showed that 80% of GP partners will pull out of the network DES contract unless NHS England's proposals change.

In a new BMA survey carried out before the specifications were published, it was revealed over one in ten clinical directors of PCNS already planned to quit their role within the next year

Yesterday, NHS England's director of primary care and system transformation Matt Neligan admitted that changes to the proposed PCN DES contract are needed to ensure practices can deliver the specifications. 

The RCGP previously issued a warning to NHS England that its consultation period on the DES matter was ‘far too short to be meaningful’.

Readers' comments (13)

  • Vinci Ho

    I hope you understand that a political problem needs a political solution . And this draft document had clearly stated that the ‘evidence’ used by NHS England came from consulting various organisations including RCGP , BMA, Public Health England etc .Hence , you and your college has arguably ‘facilitated’ this debacle created by NHSE (so was BMA) . Foes or friends , I am sure that you know which side you want to position yourself , Professor .

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  • You have lost the majority of those you allegedly represent by this collaborative effort with the powers of darkness.You are gonna have to build some pretty robust bridges matey.

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  • Nowhere near strong enough, Martin. If you speak for the profession, tell them we’ve long since had enough. Those of us in exile aren’t coming home until this is fixed.

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  • This is the job of the BMA, not the cardies, God help us all

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  • All the extra work must be tied to increasing GP numbers.
    6000 extra GPs is what is needed to maintain current services. You can add in an extra 500 per year for increasing demands in appointments, increasing chronic illness etc.

    Any extra work needs to be represented in top of that. And the increase in numbers must be achieved before extra work can be added.

    So if 6000 extra GPs are needed now.
    and 2500 extra over the next 5 years - just to maintain the status quo - that is 8500.
    The first specification can be started IF there are 10000 extra GPs over the next 5 years.
    If there are 12000 extra GPs then 2 specifications can be activated. etc etc.

    We all know the chances of boosting GP numbers by that amount is pretty close to nil

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  • RCGP should stay out of politics and concentrate on education. The last thing this profession needs is more politicos

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  • This is for the BMA not the RCGP. When you loose your focus you will not do anything well.

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  • yes but the BMA is very ineffectual so im glad the college is saying something - i suspect this is the first time they have tried to actually represent the views of the grassroots - certainly since ive been paying them (and not)

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  • The RCGP are completely out of touch, again. Nearly everyone else knows PCNs at best will not help, and in current form make things worse. Scrapping not renegotiation is the correct response.

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  • I agree scrapping PCNs not renegotiation is the way forward. RCGP again failing to reflect the views of many of its members.

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