This site is intended for health professionals only

BMA demands another PCN DES opt-out window over enhanced access

BMA demands another PCN DES opt-out window over enhanced access

Exclusive The BMA has demanded that GP practices get another chance to opt out of the PCN DES if they cannot agree an enhanced access delivery plan with commissioners, Pulse has learned.

Practices in England had until 30 April to opt out of the DES without breaching their contract as part of the annual opt-out window.

PCNs must now submit plans to commissioners by 31 July for the new enhanced access service – which requires them to offer appointments 9am-5pm on Saturdays and 6.30pm-8pm on weekdays – ahead of the service’s launch in October.

But Pulse has learned that the BMA’s GP Committee has asked NHS England to open ‘another opt-out window’ so that practices who ‘cannot agree’ a ‘safe’ model can withdraw from the DES.

GPC England deputy chair Dr Kieran Sharrock told Pulse: ‘The opt-out window for the PCN DES has now closed, but the BMA remains open to discussions with NHS England and NHS Improvement about how to improve the flexibility of the programme.

‘PCNs have until July to agree plans for extended access with their CCG and we have requested from NHSE [that] another opt-out window be opened, so that practices who cannot agree a delivery model with their local commissioner – which is safe for both patients and the limited number of primary care staff we have – can withdraw from the DES.’

Dr Sharrock added that patients should be ‘reassured’ that practices will only withdraw from PCNS ‘if they think it is safe and in the best interests of their communities’. 

‘Any practice which opts out will continue to look after patients, but without additional unachievable targets that could be taking them away from addressing the unique needs of that particular community,’ he said.

The BMA last month said that NHS England rejected its requests for certain relaxations of the DES, including around Saturday opening times and GP availability for the new extended hours service.

It has repeatedly encouraged practices to consider their ongoing participation in PCNs.

It comes as Pulse revealed last week that NHS England has confirmed a GP must be physically present at all times during PCN weekday evening and Saturday enhanced access appointments.

Previously, the GPC advised that a GP must be ‘available’, but not necessarily ‘physically’ present during enhanced access shifts offered by PCNs under the new DES.

Pulse also revealed last month that PCNs will need to provide GP appointments covering the ‘full’ periods of 9-5 on Saturdays and 6.30pm-8pm on weekdays.

What is the PCN enhanced access service?

The network DES set out the requirements for PCNs to provide enhanced service access from 6:30pm to 8pm on weekdays and 9am to 5pm on Saturdays.

Under the requirements, networks will have to provide 60 minutes’ worth of appointments per 1,000 population within the network, delivered within the hours stipulated.

The appointments will be available ‘for any general practice services and services pursuant to the Network Contract DES that are provided to patients, the DES says. It also says that they should be bookable a minimum of two weeks in advance, and that same day appointments should be made available.

The service will go live in October, when it will be funded £7.46 per patient pro rata. Until then, networks will receive 72p per patient for the preparatory arrangements.

PCNs must submit plans to commissioners by 31 July, which will set out the mix of services to be provided, how networks will offer appropriate levels of face-to-face appointments and what locations are to be used.


Patrufini Duffy 6 May, 2022 3:16 pm

Not really. Practices have had plenty of time to self-reflect. Those that decided (somewhat naively) out of casual sheepish behavior to merely “fit-in” do so for mere pocket money, whilst they’re still in the game. Advocating their own demise. How bizarre. There is no evidence that a PCN impacts outcome or provides anything better than a superb, small, well-oiled machine of a practice with good referral routes outward. The PCN merely increases ambiguity, fragmentation and encourages work-transference from Secondary into Primary care. Procurement – we all love a procurement and sticky plaster.

As for the mega site PCNs – you know the ones, where basically there is no working together, just the same branch sites all under one umbrella of 60,000 patients et al. – well, they are laughing at essentially free pocket money propping up their mega business models. So they Opt-In. Yes please. And they still won’t pick up the phones or see the patient, which is mathematically impossible with all those ARRS props, winter monies and pound signs floating around. The Opt-in is a decision of either being scared of the system looming, or not knowing what or how dangerous that system even is. Just close your eyes and believe that “they” will look after you. And to fleece what monies you can prior to jumping ship, whilst running your site into the ground. The PCN is one place where there is no safety in numbers, just a mirage illusion. In fact, your expert voice just got obliterated under a grey and inert banner term like “The South West Riverside PCN”. Whatever that means. Doing tasks that you don’t even believe in, nor are meaningful for your patient area. Which you do realise actually does threaten your GMS/PMS contract if you do not fulfill core duties. They just herded you up and now have 1 director to talk with, over a Zoom call – instead of 6-20 experienced Partners – well done. Just more tax to pay back and sweat to drip. You will soon enjoy seeing other practices patients on the weekend. And those failing super practices that just dump the workload into you. That dynamic will be very interesting. The monitoring will be intense and data collection stern. It is taxpayers money after all, NHSE doesn’t give free money, and the hard work begins now; and the comparisons will be made between site “performance” (remember, they were going to name and shame you not long ago). But, we will watch what happens as winter approaches, vaccines wane and viruses say hello and deconstruct business continuity and summer optimisms. Patient amnesia is well set. Hypothetical working, you took their bait again, to be essentially drained even more existentially.