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GPs given fortnight to vote on future of PCN DES


BMA reject health and care bill


GPs in England have been given two weeks to vote on the future of the Primary Care Networks (PCN) DES.

The BMA has urged GPs to ‘consider the potential implications and consequences’ of their vote.

In November, GP leaders attending England’s LMCs conference voted in favour of putting the PCN DES to a ballot of the whole GP profession.

The BMA today announced that polling is open for all practising GPs in England – including partners, sessional GPs and trainees – on whether the DES ‘should continue’.

GPs will be able to cast votes from today until 23:59 on 19 January.

The ballot asks: ‘Prior to any further negotiations, extension or changes for 2021/22, do you give GPC England a mandate for the PCN directed enhanced service?’

The BMA said this would inform ‘future negotiations’ – with GPC continuing to negotiate ‘amendments’ to the DES for its remaining three years if general practice votes in favour.

This would cover the service specification, further workforce expansion, the investment and impact fund and ‘how the access scheme funding can be used’, it added.

Amendments would be negotiated and implemented annually, although timelines ‘may change in order to support general practice in responding to the current pandemic’, the BMA said.

Practices would retain the opportunity to opt out of the DES ‘within the annual window’, it added.

However, the BMA warned that if GPs vote against the mandate, ‘GPC England will be unable to continue discussions with NHS England regarding the DES’.

It added: ‘It will then be for NHSE England to decide how it wishes to proceed with arrangements for PCNs and the DES with its associated funding.’

This could include offering the DES to practices ‘without GPC/BMA involvement in its continued development’, transferring the requirements and associated funding to non-GP providers and removing ‘some or all of the funding’ to be used ‘elsewhere’ in the NHS, it said.

The BMA added: ‘NHS England and Government have consistently stated that PCN DES funding would not be made available for investment directly into global sum or other core elements of the practice contract.

‘It is therefore extremely important that participants consider the potential implications and consequences of a yes or no vote.’

The motion passed by delegates at the England LMCs conference in November with a 62% majority said the BMA’s GP Committee ‘has never secured a robust democratic mandate for the PCN DES’.

The introduction of the PCN DES last year was mired in controversy, including becoming subject to a special LMC conference which voted to reject it.

After it was endorsed by the GPC, 98% of practices signed up to the DES in May. 

At the time, NHS England’s announcement said that the ‘near total’ uptake ‘reflects support’ for PCNs which are ‘helping improve care for patients across the country’.

Practices were also given an opportunity to opt out of the DES in September, after NHS England updated it.

READERS' COMMENTS [15]

RAMAN PRABU 6 January, 2021 6:18 pm

What is the point of frightening the wits out of GP’s with above statements by GPC and then asking to Vote.
Any contract changes or negotiations by GPC Should routinely be put to vote electronically as we have the technology and our future should not be decided by a few people at the top

Douglas Callow 6 January, 2021 7:32 pm

May be too late to say no as ICSs likely to get primary legislation and the usual spread of opinion regarding PCNs ?

Andrew Jackson 6 January, 2021 8:38 pm

The PCN DES was meant to give us a less intense and more sustainable day job.
All the new team members have negotiated exactly that whilst my job is no different yet the Government will have no additional money to invest in primary care after this.
Once the Covid diversion is dealt with and we return to the normal inability to control workload the exodus will continue.
It is so defeatist to say we can’t choose a different direction.

Douglas Callow 6 January, 2021 8:47 pm

Not being defeatist just suggesting how this may well out
The BMA are suggesting that if you vote no, NHSE will leave us with even worse deal
My pragmatic colleagues feel its hard to argue against that
But if the profession votes yes by a huge majority, that will be the end of the debate.
Maybe the best we might end up with is a sizeable ‘no’ which might frighten GPC into taking a much harder line in negotiations.
Time will tell

Manu Agrawal 6 January, 2021 11:04 pm

The mandate was to get a vote on the PCN DES, not a mandate whether GPC should continue negotiating the PCN DES or not. They’ve manipulated the vote and clearly trying to scaremonger the profession into voting for this.

I feel let down and cheated by this.

Patrufini Duffy 6 January, 2021 11:19 pm

The aim of the PCN is to silence individual practices. Why deal with 20 partners when you can instruct one clinical director? You can herd sheep better when you shackle them together. Look at what they’re doing to you, it is a masterful plan. We’ll done Ed Waller.

Decorum Est 6 January, 2021 11:32 pm

PDuffy – are you seriously suggesting that GPs are ‘sheep-like’???

Vinci Ho 7 January, 2021 7:36 am

I have said at all levels( LMC , CCG and in front of NHS England subordinates) that I am always a PCN-sceptic but would still engage as a Clinical Director and many of you probably had read my comments on this platform throughout the years .
All I said on this matter is ( of course , you can disagree with me), just cast your vote despite what others said . As far as democracy is concerned, the highest the number of votes cast , the best . Whatever the result is , the flag of general practice still needs to fly .
My view

Michael Mullineux 7 January, 2021 1:49 pm

Please vote whatever way you choose as per Dr Ho above.
Personally, it’s a resounding NO. Funding may have ‘flowed’ into PCN’s, but most appears to have flowed straight out again to various ARRS roles of dubious benefit at best; salaries of PCN directors and administrations. Further, the DES funding with so many requirements of poorly evidenced benefits looks cost neutral at best. And the problems with experienced GP numbers falling persists. We do not have to be members of PCN’s to work together in localities. Threats of funding withdrawal should not be a deciding factor in my book and seem a very underhand negotiating tool that should be summarily rejected. We as a practice are perfectly happy to manage costs and stick to core services if that is what it takes, but this PCN contract should be consigned to history as soon as possible.

Patrufini Duffy 7 January, 2021 2:16 pm

Decorum Est. Well picked up. Sheep fear. Lions don’t.

Douglas Callow 7 January, 2021 3:28 pm

Core funding may not be enough?!

Tim Irvine 13 January, 2021 6:36 pm

I think the wording of the document put out by the bma is wrong and should be put as yes or no to the pcn des. It currently reads as though bma trying to scare people into sign up, because if they don’t sign up they realise they don’t truly represent the profession and a good few should walk away from their jobs

terry sullivan 13 January, 2021 7:16 pm

nhs=political and will never change

bma, as always, not your friend

C Ovid 14 January, 2021 12:00 pm

?

C Ovid 14 January, 2021 12:03 pm

Lots of challenges coming for the NHS, most of which will empower the clinicians, whose numbers will be dwindling. Why sign up for anything right now? This government has repeatedly shown that it gives in to any pressures without much resistance (eg free meals). I advise waiting!