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BMA GP Committee to discuss PCN withdrawal this month

BMA votes to organise GP withdrawal from PCNs by next year

The BMA England GP Committee is set to ‘discuss’ how it will ‘enact’ policy to withdraw GP practices from PCNs this month.

Last month, doctors attending the BMA’s Annual Representative Meeting (ARM) voted in favour of GP practice withdrawal from PCNs by next year, with PCN funding to be moved into the core GP contract.

This made the move official BMA policy at the highest level.

Now, the GPC has said it will ‘discuss [how] to enact this new policy at its next meeting’, which is due to take place this month.

The latest GPC bulletin said: ‘It’s clear from this result that there are ever-growing concerns about how well PCNs are actually working and whether all practices can provide the safe, quality care they want to for their patients within the constraints of the current NHS system as organised. 

‘GPC England will discuss [how] to enact this new policy at its next meeting.’

An email bulletin from Cleveland LMC, which shared the same notice, added that this will take place ‘in July’.

In May, the GPC committed to policy that PCNs pose an ‘existential threat’ to the independent contractor model.

The 2020 England LMCs’ conference had voted in favour of a similar motion, meaning this should have already represented GPC policy for the last two years, but Pulse understands this was the first time the GPC had actively voted for the policy.

The BMA’s indicative ballot in November showed over half of GP practices were willing to opt out of the PCN DES as part of a range of protest measures concerning the Government’s GP access fund.

The ARM motion, passed in full last week, also instructed GPC England to ‘act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contract including industrial action if necessary’.

Speaking during the debate, BMA representative body (RB) chair Dr Latifa Patel confirmed that the RB ’can instruct GPC England’ as set out in the motion.

It comes as the NHS Confederation has warned that withdrawing from the PCN contract will worsen practices’ workforce challenges and will risk stifling primary care’s voice at system level.

GPs should not underestimate the value of ‘at scale’ primary care, it said, particularly in light of increasing patient demand, ‘insufficient’ estates and a ‘crippling workforce crisis’.

Responding to the vote to pull out, NHS Confederation chief executive Matthew Taylor said: ‘Due to the significant disruption caused by the pandemic, it is simply too early to write off PCNs as their true potential is yet to be seen.

‘PCNs and neighbourhood teams offer the only tangible mechanism to deliver comprehensive healthcare for patients in their local communities, bolstered by new additional roles, such as social prescribers, mental health practitioners and community pharmacists.’

He added that the contract ‘needs to give PCNs and their partners the freedom and autonomy to work out what’s right for their local communities and staff’.

Mr Taylor also noted that all 42 integrated care systems (ICSs) signed the recent Fuller stocktake review, which recognised the ‘integral role’ primary care will play in the new NHS system.

He said: ‘If GP practices walk away from the PCN contract, this vital voice of primary care at a system level is at risk.’

Pulse recently revealed that only GPs with PCN director experience will be eligible to apply to sit on integrated care boards (ICBs) in some areas of England, prompting criticism that LMCs were essentially excluded.

Representatives at the ARM also voted in favour of pushing for LMCs to be represented on the boards of ICSs.

Motion in full

Motion by LONDON REGIONAL COUNCIL: That this meeting supports GPs fighting to defend the GMS contract and NHS independent contractor status. The long-term GP-patient relationship and the right for GPs to control their workload in a safe way is essential for the future of general practice. We applaud the South Staffordshire motion passed at the 2021 LMC conference which called for GPCE to negotiate the end of the Primary Care Networks (PCNS) from 2023 as they ‘pose an existential threat to independent contractor status’ and this meeting:- 

i) calls on GPCE and the BMA to organise the withdrawal of GP practices from the PCNs by 2023; PASSED

ii) calls for PCN funding to be moved into the core contract; PASSED

iii) instructs GPC England to act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contact including industrial action if necessary.  PASSED

Source: BMA


Darren Tymens 6 July, 2022 4:21 pm

If the system wants something to perform the function of PCNs, then it needs to
– fund their constituent practices properly, and guarantee the independent contractor model as an option
– commit to matching funding to practice workload, with no new workload without new funding
– deliver all care that can be delivered at practice level, at practice level
– only ask PCNs to deliver those things that require practices to collaborate at scale, and not directly compete with practices for funding
– end PCN-level IIF and QOF etc
– have a mechanism for innovation and delivery at locality scale that is free from unhelpful and obstructive NHSE micromanagement – PCNS are not this
This is not complicated. If they don’t commit to the above, it is because they want PCNs to replace practices, and we should abandon them in their current form as an existential threat to professional autonomy and the independent contractor model.

Patrufini Duffy 6 July, 2022 4:26 pm

This is voluntary. People are acting like they were forced to do it. Wake up.