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Primary care network serving 80,000 patients collapses due to DES concerns



Exclusive A primary care network (PCN) serving 80,000 patients has collapsed due to concerns about the care homes requirements of the network DES.

All seven practices that made up the Skegness and Coast PCN in Lincolnshire have withdrawn from this year’s DES because ‘recruitment and resourcing constraints’ mean they are ‘unable to envisage’ the delivery of the services, they said.

It comes as Pulse revealed that PCNs in Kent are ‘in danger of folding’ over similar concerns while two PCNs in Buckinghamshire and Milton Keynes had previously opted out of the DES due to the workload involved.

In a letter to commissioners seen by Pulse, GP partner Dr Stephen Savory said his practice and three others in the PCN cover 26 care homes and asked Lincolnshire CCG to advise how they can deliver the specifications to all residents ‘with the inadequate resources available’.

He said: ‘The seven GP practices in Skegness and Coast PCN individually stated that they would withdraw from collective provision of the 2020-21 PCN DES, unable to envisage delivery of the Enhanced Health in Care Homes specification to our demographic, with the recruitment and resourcing constraints we face.’

Two neighbouring PCNs have said they ‘do not have the capacity’ to deliver the PCN DES for the population of 80,000, which is currently not covered by a PCN, he added.

And Dr Savory and his colleagues are concerned that there is no network in the area to ‘facilitate primary care’s response to, and recovery from, Covid-19’, he said.

Meanwhile, the letter added that a proposed new PCN involving three coastal practices previously within the original PCN could undermine the ‘sustainability and quality of primary care’ in the area due to the movement of staff.

It said: ‘Our practices fear that additional support for the putative Skegness and Mablethorpe PCN will consist of the preferential deployment of existing human resources to the coast (eg specialist practitioners) at the expense of the inland population.’

Dr Savory warned of an impact on ‘patient safety’ and that the resignation of the PCN’s clinical direction means that patients now ‘lack clinical advocacy’.

In the run-up to the deadline on 31 May, the BMA warned that practices not signing up for the network DES ‘risk losing influence’ over the development of GP services in the future.

But Pulse revealed that PCNs in Kent were under threat due to large practices opting out of the DES because of the enhanced health in care homes specifications.

In April, Berkshire, Buckinghamshire and Oxfordshire LMCs told practices that they ‘cannot advise signing up for the network DES’ in light of ‘significant concerns’ over its workload requirements.

And Pulse revealed last month that an 85,000-patient PCN in Buckinghamshire and a 40,000-patient network in Milton Keynes had already opted out of the DES – with other PCNs in the regions ‘planning to follow suit’ in the coming weeks.