First local PCN DES variation wins backing from every GP practice
Every GP practice in Kent and Medway has signed up to a ‘neighbourhood’ care model using existing PCN contract arrangements.
All 140 practices in Kent and Medway are now signed up to the £10m Single Neighbourhood Health (SNH) offer to support patients with frailty, according to the ICB.
As previously reported, NHS England approved the ICB’s request to offer GPs the local variation to the Network Contract Direct Enhanced Service (DES) last month.
This followed new powers given to ICBs to vary the PCN DES at a local level with the approval of NHS England earlier this year.
The Kent and Medway PCN DES deal is the first to make use of the lever, which experts have told Pulse could potentially ‘kill the possibility’ of the single neighbourhood provider contracts announced in the 10-year health plan.
As part of the deal, GP practices will focus on around 92,000 patients including care home residents, people on palliative care registers, and housebound patients living with severe frailty.
Interventions will include advance care planning discussions, comprehensive geriatric assessments and structured medication reviews.
The ICB said the deal will now give general practice ‘a leading role’ in shaping the new neighbourhood arrangements, while also providing ‘sustainable funding’ and ‘retaining existing core contracts’.
Kent LMC chair Dr Gaurav Gupta said: ‘The achievement of full sign-up demonstrates the strong partnership between practices, PCNs, Kent LMC and NHS Kent and Medway, and provides a solid foundation for the next phase of implementation.
‘We would like to thank practices and PCNs for the time, effort and collaboration that has gone into getting us to this point. We recognise the scale of the change and the commitment shown across primary care to make this a success.’
NHS Kent and Medway ICB deputy chief medical officer Dr Ash Peshen said: ‘We are delighted to confirm we have full participation across Kent and Medway for [single neighbourhood health]; this is a significant milestone for our residents.
‘Through SNH, practices and PCNs will lead delivery of proactive, multidisciplinary neighbourhood care focused on those who are most likely to benefit from coordinated support.’
Dr Gupta and Dr Peshen wrote in Pulse about the Kent and Medway neighbourhood contract last month.
Around the same time, the BMA advised PCNs to reject proposals to pilot single neighbourhoods if they lack ‘sufficient’ funding.
The union had anticipated that the new ICB powers would mean additional local services can be commissioned under the DES, removing the need for additional separate contracts to be commissioned by the ICB, but said that if additional funding isn’t attached to the pilots, PCNs should reject them.
NHSE has said that 2026/27 would now be ‘a developmental year’ for the new contractual models despite the contracts initially being expected at the end of last year.
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