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A faulty production line

Networks are open to manipulation

Editor’s blog

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The English contract was announced in January, yet we are learning more and more about it every day.

This week, Pulse has revealed that networks – the groups of 30,000-50,00 patients – will not have to have a clinician lead. But, more importantly, there are suggestions that CCGs are trying to manipulate the networks to fit in with their own plans.

The problem is, this is not a surprise at all. CCGs are the arbiter of what constitutes a network. And they are the ones ultimately accountable to NHS England. So it stands to reason that there will be some that will want to impose a structure on practices.

It wasn’t meant to be this way – networks are supposed to be GP-led. But the very nature of them means that this is open to manipulation.

In balance, I still think that the new contract will lead to improvements in general practice. But I can imagine we will find some more unwanted surprises as the months go on.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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Readers' comments (2)

  • Vinci Ho

    I think the government and NHSE have a choice to make . If they refuse to ditch this culture of top-down control through initially CCGs ( now GP networks) , more GPs will leave in an even shorter space of time ahead ,as well as much less young blood joining into the frontline to deliver services .
    As your previous editorials commented , this contract has not really revealed tangible solutions to the enormous workload ( both necessary and unnecessary) GPs facing everyday . The intentions of the government to ‘value’ GPs in this contract remain only ostentatious . In fact , the overall workload might eventually increase instead .
    Alongside with contentious issues of state-backed indemnity scheme , fiasco of Capita in GP support services and pension collections and the stifling arrangement of personal tax allowances versus pension contributions, NHSE and the government are long way from drawing a truce with us . Comparatively , we cannot be as intransigent as EU in terms striking a proper ‘deal’ . But what the hell , I suppose nobody dares to say that the government needs us even more than EU?!

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  • I force myself to try to be positive about PCNs.
    However I have seen so many changes and reorganisations of health care provision in my career and so much of it has been for short term political gain, by providing sound bites for which ever health secretary and government happens to be in power at the time.
    I fear this may end up just being another of those projects which fades away in a few years when the money dries up and political priorities change.

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