GPs given extra opportunity to opt out of PCNs

GPs currently have an extra opportunity to opt out of the network DES without breaching their contract, the BMA has said.

In its latest bulletin, the GP Committee highlighted that the recent updates to the network DES have triggered a new opt-out window, meaning GPs can decide to quit PCNs now – ahead of the annual opportunity in April.

Last month, NHS England announced a series of measures to support practices over the winter, including sweeping changes to the PCN DES.

The GPC bulletin said: ‘As these changes have been introduced by NHSE in-year, an opt-out window for the PCN DES has been triggered.

‘Within this opt-out window, practices can choose to opt out of the DES without risking a breach of contract.’

New BMA guidance updated yesterday said that the opt-out window, triggered by the publication of changes to the contract on 1 October, will run until the end of the month.

It said: ‘We encourage all practices who may be considering this question to reflect on the recent changes to the DES, as well as the current impact of the PCN DES on the practice and its patients.’

The guidance said that ‘opting out could free up significant portions’ of GP and practice staff time.

However, it added that there ‘may be significant financial consequences associated with opting out, though practices could see this as a fair trade for the reduction in workload this choice may entail’.

Practices considering opting out should be aware of any ‘liabilities’ they may hold regarding ARRS staff, as well as a potential ‘loss of capitation’ if patients decide to switch to a practice that delivers DES services.

The bulletin said: ‘We would advise practices to read the guidance and consult with their staff and fellow PCN members as to whether to utilise the window to leave their PCN.

‘If practices choose to stay in their PCN, the next op-out window is expected to be April 2023.’

The BMA stressed that the guidance ‘does not constitute legal or financial advice’ and that practices should ‘seek independent expert opinion before deciding whether to opt out’.

The new GPC bulletin also included a poll on what practices would ‘be willing to give up in order to reduce [their] workload’, including ‘being part of a primary care network’.

Options also included seasonal vaccinations such as flu and Covid, routine vaccinations, QOF and the Investment and Impact Fund (IIF) – the PCN incentive scheme.

The bulletin said the results of the poll would ‘help inform thoughts at GPCE and in negotiations’.

NHS England had rejected BMA calls to give GPs another opportunity to opt out of the PCN DES before April 2023 earlier this year.

And doctors at the BMA’s annual representative meeting, held in June, had voted in favour of GP practice withdrawal from PCNs by next year, with the doctors’ union instructed to ask for related money to be moved back into core practice funding.

What is happening with PCNs?

The BMA England GP Committee said it would ‘discuss’ how it will ‘enact’ policy to withdraw GP practices from PCNs in July, after GP withdrawal from PCNs by next year became official BMA policy at the highest level.

It followed a GPC commitment to policy that PCNs pose an ‘existential threat’ to the independent contractor model in May.

The 2020 England LMCs’ conference had voted in favour of a similar motion, meaning this should have already represented GPC policy for the last two years, but Pulse understands this was the first time the GPC had actively voted for the policy.

The BMA’s indicative ballot in November last year showed over half of GP practices were willing to opt out of the PCN DES as part of a range of protest measures concerning the Government’s GP access fund.

And while data obtained by Pulse last month revealed more than 99% of GP practices signed up to the 2022/23 Network Contract DES, dashing speculation of a mass PCN exodus, GP leaders stressed this is not emblematic of GP enthusiasm for the DES.