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A quarter of GP partners still unsure about signing up to the Network DES

Network DES

Exclusive As many as a quarter (25%) of GP partners are still unsure as to whether they will sign up to the 2022/23 Network DES, a Pulse survey has revealed.

This comes just two weeks ahead of the 30 April deadline for practices to either sign up to, resign from or pass on the contract.

The survey of 155 GP partners, carried out last week, found that around two-thirds (66%) do intend to sign up, with only a handful (4%) having decided against it.

Partners who are as yet undecided warned that while they cannot take on the extra work – such as delivering the extended access service – they also cannot take the ‘financial hit’ from pulling out.

Among those who will sign up, some noted that although doing so will make more funding available to practices, there is a concern that the DES will now act as the ‘only route for funding into general practice’.

The new partner survey largely mirrored a previous Pulse survey of 370 GPs (also including non-partners), which was carried out in February. This had found:

  • More than half (58%) of GPs understood their practice would sign up to the DES this year;
  • Nearly a third (30%) had not yet decided;
  • Around 5% said their practice would not sign up to the contract;
  • 3.5% would be dropping out

This comes as in 2020/21, nearly all GP practices (98%) signed up to participate in the Network DES.

The long-awaited specification for the new Network DES was published in full earlier this month (1 April), clarifying the new funding available for participating practices, and offering further details on additional services they will be expected to deliver.

Notably, under the updated contract, GPs in England’s PCNs will be required to open between 9am and 5pm on Saturdays. Although the BMA GP Committee has since advised that a GP does not have to be ‘physically’ present so long as they are ‘available’.

Recent analysis by one LMC found that the updated PCN DES offers an overall net funding increase of £2 per patient, but said that this does not recognise the ‘significant’ increased workload to practices.

Dr Michael Mullineux, a GP partner at the Symons Medical Centre, which will not sign up to the DES, told Pulse: ‘The DES is nothing more than un-resourced extra work removing yet more clinicians from patient contact to undertake administrative tasks set by NHS England.’

He told Pulse that he believes that aspects of the DES, such as expecting practices to deliver multiple additional services, has increased workload without relieving pressure on general practice.

Dr Kate Harvie, GP partner at Hillside Practice in Cleveland, said she feels there is ‘no option but to sign up’, noting the added expectations the DES sets on practices.

She said: ‘As we always have done, we will continue to do our best to jump through the various hoops we are set while trying to make it all work for the patients.’

A GP partner who wished to remain anonymous, and whose practice will remain in the DES, commented: ‘Without the meagre scraps that trickle down from the PCN we will be financially finished by the rises in NI and wages, utilities, and other inflationary pressures.’

Another partner who wished to remain anonymous said they would remain in the DES to ensure staff they have hired via the additional roles reimbursement scheme (ARRS) are not let go, noting that it would be difficult to retain them without the ARRS funding.

They said: ‘I want to do my utmost to continue to employ them, both from loyalty to them as colleagues, and recognition of their important contribution to patient care and management of workload.’

A BMA spokesperson said: ‘There are clearly significant concerns about the PCN DES, which we share. We are still discussing this with NHS England and NHS Improvement and as such, cannot comment any further at this stage.’

NHS England did not provide a comment.


Patrufini Duffy 14 April, 2022 11:20 pm

Your spine is located approximately between your brain, and rectum. Opt out.

Paul Attwood 14 April, 2022 11:56 pm

Lemming season it seems?

David Church 15 April, 2022 4:00 am

The ‘extra funding’ will surely be not enough to fund Reception staffing for Saturdays, (even at minimum wage -aand they deserve more than that), leave alone ANY clinical staff at weekend rates!
Only super-big practices will be able to make any gain on the funding versus the costs, and even then I am not sure : plus –
Who wants to work weekends as well as weekdays, amongst your non-GP staff?
Where will you find extra GPs for the wekend work?

David Banner 15 April, 2022 9:12 am

It’s a simple choice.
Would you like to be …..
a) worked to death, or…..
b) starved to death
Either way the partnership model collapses and we are herded into Trusts, which as we now know is our Final Destination.

Not on your nelly 15 April, 2022 2:56 pm

Spot on both David’s.

Sadly in our patch we only have a Hobsen’s choice, as we are required to be in a PCN in order to access additional local enhanced service income.

Patrufini Duffy 19 April, 2022 2:22 pm

I somewhat feel sorry for the unsure 25%. It’s a bit sad. It’s like a sheep, offered the pen or pastures and they don’t know where to go, because they’re scared of the Shepard, and don’t want to let the hungry consumer down.

I should trademark that analogy.