Exclusive PCNs were ‘fed as a lie’ to general practice in England, according to the BMA’s GP committee chair.
Dr Katie Bramall-Stainer told Pulse that during the 2019/20 GP contract negotiations, the GP committee was told to vote in favour of the PCN DES because the promised funding would otherwise ‘go to community trusts’.
She also said that it subsequently ‘became clear’ that community trusts were ‘in no shape to take on services required of the PCN’ and that therefore ‘GPC England was fed a lie’.
After the DES was endorsed by the GPC, 98% of practices signed up to it and NHS England said that the ‘near total’ uptake ‘reflected support’ for PCNs which were ‘helping improve care for patients across the country’.
Dr Bramall-Stainer said: ‘I was always against the PCN DES, but I voted for it because every single member of GPC England voted for the PCN DES apart from one member, who chose to abstain.
‘And it was because we were told “if you don’t go for this, [the funding] will go to community trusts” and “if you don’t go for this, you won’t have Crown-backed indemnity”.
‘This is not what the executive team believed, it’s what they were told by their then NHS England colleagues.’
She said that at the time that there were GPs being ‘prevented from practising’ because they were facing ‘such staggering sums of indemnity costs’.
‘We can now look back with the benefit of hindsight and actually some indemnity organisations were facing financial pressures of their own, where this actually was going to be a compulsion upon Treasury to find a solution,’ she added.
‘We can see that actually community trusts are in no shape to take on the services that are required of the PCN. So on the basis of those examples, I believe GPC England was fed a lie. But that was then and this is now, and we have to look forward, we have to be realistic.’
Her comments come as the current make-up of GPC England is working on an LMC mandate to exit the PCN DES.
The BMA first passed a vote in favour of scrapping PCNs at its Annual Representative Meeting in 2022 and last year, in a ‘call to action’ document setting out points for contract negotiations, the GPC called for a unified contract with all funding coming through one route with sufficient resource to enable practices to deliver core services.
The GPC has previously said the PCN DES has proven to be ‘a failed project’ to be replaced with a quality improvement-based contract.
But when asked by Pulse if she thought PCNs were going to be scrapped, Dr Bramall-Stainer responded that they are ‘the only show in town as far as the Department of Health and NHS England are concerned’.
She added: ‘Working at scale appears to be the only show in town as far as many other parties’ aspirations are concerned. But I think it’s a fluid conversation.
‘And it is beholden on us at GPC, on LMCs across the country, on practices across the nation, that we make the case for the strength of the local surgery.
‘And we have to be responsible about where we are, and recognise that this is not just people’s careers, not just their livelihoods, it’s their businesses that they also owe to their members of staff and their patients that they have known for decades.’
An NHS spokesperson said: ‘The five-year contract framework agreed between NHS England and the GPC in 2019 saw an increase in funding to general practice of more than £4billion and was warmly welcomed by the BMA GPC at the time.
‘It not only secured extra investment but brought a new multi-disciplinary workforce to support primary care, removed the worry of ever-increasing medical indemnity costs, enabled practices and patients benefit from digital technology and helped practices to work across neighbourhoods to better support local communities.’
In January 2019, Pulse revealed exclusively that GP practices in England could expect changes to their contract mandating them to join primary care networks of 30-50,000 patients in return for a major funding boost.
In an exclusive interview with Pulse last year, NHS England primary care director Dr Amanda Doyle said that ‘there is absolutely no risk to PCNs’.
The GPC is currently still in negotiations for next year’s GP contract, and Dr Bramall-Stainer told Pulse that a Government offer for the contract will be put out to referendum by the BMA next month.
READERS' COMMENTS [7]
Please note, only GPs are permitted to add comments to articles
It would have been a lie for NHSE to say ‘If you don’t vote for this, PCNs will do the work’; but It does not really seem like a lie as such to say ‘If you don’t vote for this, the money will go to PCNs instead’.
PCNs have been shown to be quite capable of soaking up extra additional funding.
It is the outcomes that theree is less evidence for.
There were several other questionable statements from NHSE too, but what can you expect from such a corrupt Government as we currently have?
The damage caused by PCNs and PCN Clinical Directors will only emerge in later years in my opinion. This is a yet another hidden scandal of untold legendary proportions.
There has been widespread abuse of NHS funding within PCNs scrambling to appoint any person for certain ARR roles just to use up NHS funding as directed by NHSE to satisfy ill thought-out deadlines leading to the creation of on occasion obscure roles and individuals with no experience or no proven ability filling these roles. This then clouds the issues of where certain ARR roles would be of value.
This requires an urgent public statutory investigation and review into this maladministration.
Time and again NHS taxpayer funds have been misused for funding ARR roles sometimes where not required, but to the limited roles directed by NHSE where the PCN ARR is not adequately or even remotely qualified for some of the more spurious roles and monitoring of these roles has been minimal or absent with lengthy appointments for simple matters and widespread inattention to accountability for the funds used for these staff.
There is an implied duty on all staff at all levels to not mismanage NHS funding in this manner.
It is abhorrent that astronomical amounts of NHS funding have been wasted by PCNs directed by an inept faceless management group such as NHS England which has in my view one of the world’s longest track records of repeated failure and incompetence.
There can be no doubt in my opinion, that significant harm has been caused to patients who have been deprived of care due to the misdirection of NHS funding by PCNs and harm which could have been prevented had the money not been misused via PCNs and more sensibly directed to staff and services where there is a clear need. This is yet to be seen.
PCNs and the rules around how funding can be spent (i.e.not on GPs) is of course a Trojan Horse. The plan is clearly to sideline GPs, and continue the move to have Primary Care staffed by Noctors. Expect lies, misdirection and bribery. We are sheep being manipulated by wolves.
Between PCNs and ARRS, Primary Care (as we know it) in the UK is finished.
Where do we go from here?
During the last 12/12 Sunak has been quoted referring to “doctors nurses and GPs”. Perhaps he and his colleagues
(and maybe the GMC?) don’t understand that GPs are in fact doctors.
There
PCNs were ‘fed as a lie’ to GPs, says GPC chair Nooo…..Really? I cannot believe govt ministers would speak with a forked tongue!