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Primary care networks will not have to be led by GPs, says NHS England

Primary care networks will not have to be led by a GP, with ‘any clinician’ in general practice able to take charge, NHS England has said.

Under the new five-year GP contract, practices will be provided with extra funding to join networks, which will see groups of practices serve 30-50,000 patients.

All networks must appoint an accountable clinical director, who will be responsible for ensuring it delivers local services, by 15 May.

When the contract was released in January, it was widely understood that networks would be led by a single GP in a clinical leadership role, according to information provided by the BMA.

But speaking at the Londonwide LMCs’ annual conference yesterday, NHS England’s acting director of primary care Dr Nikita Kanani told delegates there is no obligation for GPs to be at the helm of networks.

When asked by a London nurse why networks would have to be led by a GP, Dr Kanani said: ‘They don’t. They’re clinically led so it can be anybody.

‘They’re remunerated at general practice level but they could be [led by] anybody who is right clinically.’

She added: ‘It should be general practice led. When I went through the contract documentation last night we made sure that it was really clear it could be any clinician.’

According to NHS England’s GP contract, the network clinical director will work with member practices to ‘improve the quality and effectiveness of the network services’.

‘Primary care network clinical directors will provide strategic and clinical leadership to help support change across primary and community health services,’ the contract states.

A BMA spokesperson told Pulse: ‘It is for practices in the network to decide who leads them. We would expect a GP to take on this role, but if the network prefers another clinician, who has the necessary skills, then they are free to appoint them too.’

Dr Yuri Pattni, clinical lead for Federated4Health – a GP federation in Haringey, north London – said he would not be against the idea of a network having a clinical director other than a GP, as long as they have the right skills and knowledge of the environment they operate in.

He said: ‘I am not averse to the idea. There could be a scenario in which different primary care networks could get together and recruit one person to manage all of them and that person could have a wealth of experience, either from the commissioning side or the provider side.

‘It’s about what’s right for the network. If a primary care network feels like they are able to take on that role having deliberately discussed it with their colleagues, then that’s fine.’

He added: ‘I would love it if it was a nurse, for example, it doesn’t matter and doesn’t have to be a GP to do this. It’s about what the role entails and what that means. You need to have an understanding of the context in which you’re operating but I think beyond that fair game.’

As reported by Pulse yesterday, it has emerged that CCGs in some areas of England have been trying to ‘manipulate’ new primary care networks to ensure they align with their own plans.

GPs told Pulse a number of CCGs have been trying to influence how networks are set up, including telling practices which GP should become their clinical director.

Timetable for network contract DES introduction

January to April 2019: Primary care networks prepare to meet the Network Contract DES registration requirements

By 29 Mar 2019: NHS England and GPC England jointly issue the Network Agreement and 2019/20 Network Contract DES

By 15 May 2019: All primary care networks submit registration information to their CCG

By 31 May 2019: CCGs confirm network coverage and approve variation to GMS, PMS and APMS contracts

Early Jun: NHS England and GPC England jointly work with CCGs and LMCs to resolve any issues

1 Jul 2019: Network Contract DES goes live across 100% of the country

Jul 2019 to Mar 2020: National entitlements under the 2019/20 Network Contract start:

  • year 1 of the additional workforce reimbursement scheme
  • ongoing support funding for the clinical director
  • ongoing £1.50/head from CCG allocations

Apr 2020 onwards: National Network Services start under the 2020/21 Network Contract DES

Source: A five-year framework for GP contract reform to implement The NHS Long Term Plan