NHS England will step in to find alternative solutions with local commissioners if PCNs cannot ‘safely’ deliver the Saturday and evening access required under the PCN DES, the BMA has said.
An update letter to LMCs from GPC England also claimed it has received guarantees from NHS England that PCNs which fail to agree safe enhanced access arrangements because of ‘insufficient resourcing’ will not be penalised.
While subcontracting would be allowed under the DES, the GPC said it had highlighted – with acknowledgement from NHS England – that this ‘isn’t always a viable option for every locality/region’.
The update said that NHS England had, during a recent operational meeting with the GPC, ‘confirmed that where PCNs and ICSs cannot agree on safe enhanced access arrangements for the new 2022/23 PCN DES requirements due to insufficient resourcing, GPCE can escalate this to NHSE/I to resolve with local commissioners’.
It said ‘representatives also confirmed there is no intention to penalise any PCN, or its constituent practices, that has not been/is not able to agree a safe solution with the ICS’.
And that ‘they are committed to working with local and regional commissioners to do everything possible to help find an alternative safe solution’.
The update also saw the GPC ask LMCs to submit ‘examples’ of instances where ‘PCNs and ICSs have not been able to agree’, which it intends to collate to show NHS England that the additional PCN DES requirements are ‘unworkable’.
‘This will then be escalated nationally for appropriate resolution,’ the letter said.
Under this year’s updates to the network DES, GPs in England’s PCNs will be ‘required to provide enhanced access between the hours of 6.30pm and 8pm Mondays to Fridays and between 9am and 5pm on Saturdays’ from 1 October.
Pulse has asked NHS England for comment.
It comes as NHS England rejected calls to give GPs another opportunity to opt out of the PCN DES before April next year.
Pulse revealed in May that the BMA had demanded that GP practices get another chance to opt out of the PCN DES if they could not agree an enhanced access delivery plan with commissioners, which had been due by last week (31 July).
Previously, the GPC advised that a GP must be ‘available’, but not necessarily ‘physically’ present during enhanced access shifts offered by PCNs under the new DES.
Pulse also revealed in April that PCNs will need to provide GP appointments covering the ‘full’ periods of 9-5 on Saturdays and 6.30pm-8pm on weekdays.
Last month, NHS England said ICSs could take on the commissioning of enhanced services such as the PCN DES.
What is the PCN enhanced access service?
The network DES set out the requirements for PCNs to provide enhanced service access from 6:30pm to 8pm on weekdays and 9am to 5pm on Saturdays.
Under the requirements, networks will have to provide 60 minutes’ worth of appointments per 1,000 population within the network, delivered within the hours stipulated.
The appointments will be available ‘for any general practice services and services pursuant to the Network Contract DES that are provided to patients, the DES says. It also says that they should be bookable a minimum of two weeks in advance, and that same day appointments should be made available.
The service will go live in October, when it will be funded £7.46 per patient pro rata. Until then, networks will receive 72p per patient for the preparatory arrangements.
PCNs had to submit plans to commissioners by 31 July, to set out the mix of services to be provided, how networks will offer appropriate levels of face-to-face appointments and what locations will to be used.