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GP issued with termination notices for failing to cooperate with PCN

GP contract

A GP partner in West London has been issued with contract termination notices for failing to cooperate with the local PCN.

The GMS and PMS contracts for 2019/20 say practices are contractually obliged to cooperate with PCNs ‘whether or not’ they are signed up to the network DES.

Non-PCN practices have a duty to inform patients of changes to PCN services, be ‘party to appropriate data sharing’, and to share non-clinical data with PCNs.

NHS Hillingdon CCG said it had to issue the notices as it had ‘not been able to reach an agreement with the contractor that would allow all patients registered at the practices to have access to the additional NHS primary care network services’.

Dr Sashi Shashikanth, a GP principal of two small GMS practices in Hillingdon, west London, who is not signed up to the DES, had hoped the CCG could separately contract his two practices to provide the services.

The GP, first warned about contract breaches in January this year, also suggested that handing over patient details to the PCN would have placed him in breach of GDPR.

He said: ’We have requested all along [for the CCG] to help us to offer services to our own patients. Instead they are pushing us into the legal option which will cost us thousands of pounds in legal fees and time at this crucial pre-winter time when we fear a second [Covid] wave is around the corner.’

An NHS Hillingdon CCG spokesperson said: ‘NHS Hillingdon CCG has made the difficult decision to end the practices’ contracts as we have not been able to reach an agreement with the contractor that would allow all patients registered at the practices to have access to the additional NHS primary care network services including Extended Hours Access, Structured Medication and Medicines Support, Early Cancer Diagnosis and a Social Prescribing Service.

‘The practices are free to decline to join a network however their patients must be able to access the same services as the rest of our population.

‘We take the health and safety of all our residents seriously and at this time we feel that whilst the care at the practice is not a concern, patients’ inability to access the full range of services available to them places them at a disadvantage if we let this continue as they will not have access to all the beneficial NHS services that have been put in place to care them.’

The CCG added that failure to accept new patients when the list was open was also part of the decision, although Dr Shashikanth said this only applied to one of his practices and that he had ‘reasonable grounds’ not to accept the allocation in question.

The CCG spokesperson continued: ‘It is with great regret that we have had to issue the termination letter and our hope is that we may be able to come to a mutual agreement with the practice that will see the matter resolved without the need for the termination notice to proceed.’

Under the notices, Dr Shashikanth has until this evening to agree a joint referral to the Primary Care Appeals Service (PCAS) for an ‘independent determination of contractual obligations’. Otherwise the contracts for the 4,700-patient West London Medical Centre and 2,600-patient Church Road Surgery will end 22 October.

The BMA and Londonwide LMCs declined to comment on an individual case.


Andrew Bamji 1 October, 2020 10:26 am

Oh boy. Here we are in the middle of an epidemic and a health authority is removing 7000 patients from GP care. I cannot believe the “shortcomings” are so bad to warrant such a step in the face of a GP shortage!

Colin Malcomson 1 October, 2020 11:03 am

At last it becomes crystal clear that PCNs are just a tortuous , time wasting and phenomenally expensive way of NHSE exerting complete control over general practice. Impose “contract” changes unilaterally at will and strip contracts whenever a practice demurs.

Not Arvind Madan 1 October, 2020 11:18 am

Better off fighting a battle which is worth winning. This is just corporate suicide.

Patrufini Duffy 1 October, 2020 1:57 pm

That is disgusting. The words racist, ageist and list size-ist accidentally just entered my head.

Neil Tallant 1 October, 2020 2:02 pm

Another nail in the coffin of the Partnership model for General Practice. Clearly there is a “Corporate” agenda progressing well but with all responsibility remaining with individuals.
Get out now guys…

Richard Greenway 1 October, 2020 3:59 pm

Sounds extremely heavy handed to remove a contract at such short notice.
Surely the PCN can advertise their social prescribing services via a website without removing all the normal GP services to those patients.

David jenkins 1 October, 2020 4:32 pm

i wonder what the patients will make of this – and the local press !

presumably the patients are fairly happy with the service they are getting – otherwise they would have voted with their feet long ago.

i doubt anyone in the health authority has explained that they are likely to get a worse service because their GP refused to be bullied by a bunch of thugs in suits !

Nick Mann 1 October, 2020 6:07 pm

I hope Dr Shashikanth will contest this all the way. PCNs voluntary?…Not. GPs in control? …Not.

Patrufini Duffy 1 October, 2020 9:05 pm

This is quite momentous. During a pandemic? Hillingdon CCGs (blinded) “vision” states: “We are made up of local GPs and health professionals who are best placed to know the right services for our area. GPs use their experience and knowledge to influence and shape the decisions the CCG makes”. They should take down that statement and replace it with…”this CCG aka NHSE makes the decisions upon GPs who have no experience and are not best placed to influence anything”. A board who stabbed a colleague and his patients in the back for a merely beauracratic and sheepish “vision” of conjured services that have no evidence base or want from the front line.

Martin Coleman 1 October, 2020 9:52 pm

What’s social prescribing??

Matthew Shaw 2 October, 2020 11:28 am

The executioners face is always well hidden. This is not a CCG decision. The real question is how NHSE have leant so hard on the CCG over this and what pressure have been exerted. Having seen it from the inside, a CCG would NEVER pick a fight like this without enormous pressure from the centre.
Its all so devious cowardly and underhand.
What are these “PCN services” actually offering patients?
The agenda is to whip us into line by sacrificing this guy.
We need a clean out these Civil servants.

T F 2 October, 2020 12:54 pm

Well said Matthew.

Hank Beerstecher 3 October, 2020 11:04 am

Dr Sashikanth, I noted a fellow foreign medical graduate running a small practice with good patient reviews: I saw you studied in Russia, but Putin has a lot to learn from the autocratic NHS that supports bullies and corporate bullying. Sadly in the UK you are alone if you are trying to defend your principles and protect your patients’ rights, contractors were sold out by the GPC in 2004. My heartfelt sympathy and praise for standing up.

Andi Williams 5 October, 2020 12:16 pm

All part if the plan to privatise the NHS.