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CAMHS won't see you now

Do we trust the PCN movement?

Dr Katie Musgrave

The stated aim of PCNs is to strengthen and redesign primary care. 

If they’re to be at all successful, the architects behind the PCN concept must understand that trust needs to be built between GPs and policymakers.

After years of system redesign, GP-bashing from all directions, and relentlessly spiralling workloads, the workforce is worn out. 

GPs are tired of being promised improvements, only to find real-term pay cuts, with increasing demands placed upon them. 

We've been demoralised by criticism from all directions - the media, successive health secretaries, our hospital colleagues… No wonder over half are choosing to retire or leave the profession.

GPs have come to expect that new services may be funded for a number of years, only to have the funding subsequently removed, with the expectation remaining that the service should continue. 

The workforce has learnt that any new service proposals at best come with strings heavily attached, and at worst may prove to be a poisoned chalice.

GPs need time, honesty and transparency to build a positive relationship again with NHS England

New service proposals may prove to be a poisoned chalice

It may well be the case that PCNs are the only way to secure general practice over the coming decade. 

It might prove essential to link surgeries together, giving support to weaker practices from those that remain more secure.

I’d argue that encouraging total mergers would be a shortsighted and damaging road to go down. However, whether we like it or not, using these networks may be the only way that primary care in England can be saved from total collapse. 

But in order for PCNs to move forward in their development, NHSE needs to show commitment to the profession. 

Not small pittances of extra funding, with unachievable targets and workload attached, but genuine concessions to recognise the strain that GPs have been under. 

There must be recognition of the ever-increasing work that family doctors have shouldered over the past decade - continuing in difficult circumstances to prop up the NHS and keep their populations healthy. 

There are various means by which NHSE could show their appreciation of our services - bonus schemes to support and retain GP partners would be a good place to start, and possibly extra bonuses for those working seven or more clinical sessions.  Continued workforce support to GPs, without countless strings attached, and meaningful interventions to reduce our workload would also be welcomed.

As a profession, we are understandably disinclined to take strike action. But the alternative means by which GPs express their disillusionment is eminently more destructive - we leave the profession

And GPs will continue to take this ‘permanent strike’ action until NHSE shows a greater commitment to building our trust, and improving our working conditions. 

PCNs are at a crucial juncture, and more needs to be done to win back the commitment of GPs.  

Dr Katie Musgrave is a GP trainee in Plymouth and quality improvement fellow for the South West

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Readers' comments (8)

  • Brilliant article

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  • Great article. Think pcn’s May lead to widespread retirement and resignation.

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  • Great, constructive, blog. I've forwarded it to my MP. Thanks for a summary that manages to make the point without sounding angry

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  • Maybe a one day national strike for routine work would have some effect

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  • Totally agree Katie, very well articulated! The truth is the next move by NHSE is going to be the key- they either change tack completely and put their weight behind supporting GPs or (which seems more true to form) continue to expect blood from a stone. If the latter path is chosen even the most ardent supporters of the NHS must realize that we are being totally abused and the BMA must give us an alternative option. Failure will be unacceptable and permanent strike action will be the only solution.

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  • wales have removed alot of QOF, started post registrar rotations to support new GPs and boosting funding to GP practices with few local services. they recognise they need more GPs and need to support them to stay, especially in more rural areas. At least they are trying and recognise there is a problem. NHSE doesn't even recognise the problem. as you say, we don't go on temporary strike, just permanent ones.

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  • Do we trust PCNs? .....No......

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  • At last a spirited article.
    I hope the author maintains her fire when she joins the top brass of the BMA, the LMC, the RCGP and the NHSE, as all those elite organisations know well how to curb the enthusiasm of young romantics.

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