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CCG’s plans for PCN deputy clinical directors set to exacerbate workload

EXCLUSIVE A CCG in the East Midlands is advertising for primary care network (PCN) deputy clinical director positions in a move that will take more clinicians out of sessions, GPs have warned.

Commissioners in the East Midlands have announced they are looking for deputy clinical directors – funded through the GP Forward View Resilience Programme – to work alongside clinical directors and support the development of PCNs. 

In briefing notes posted on the Nottinghamshire LMC website, Nottingham City CCG said the applicants, who must be clinicians working in a GP practice based in Nottingham City, will have to commit to one session a week – or four hours – for 12 months. 

However, GPs have warned these new roles will take GPs ‘out of mainstream general practice’ and impact workforce availability on the front line. They also warned that the intensity of the workload for PCNs means that others may need to appoint deputies. 

The briefing notes said: ‘The remit of the deputy clinical director role is to support the clinical director to bring practices and a range of stakeholders together to collaborate at scale for the development and delivery of service to a local population.’

Nottingham City CCG chair Dr Hugh Porter told Pulse that funding has been unlocked for eight deputy clinical directors across eight PCNs in Nottingham City. 

According to him, the funding envelope will be drawn from the £40m of the GP Forward View Resilience funding, which was initially set up by NHS England to help practices deal with workload pressures.

Dr Porter said: ‘They are funded for 12 months via some GP Forward View resilience funding, with a view to both supporting the launch and development of our PCNs giving the clinical directors extra capacity, I have described it previously as “turbocharging our PCN development”.

‘Importantly it’s also about creating an opportunity for future clinical leaders and succession planning.’

However, GPs in Nottingham said the new posts will take ‘some time out of mainstream general practice’ as the successful candidates will have to focus on and commit to their role. 

Nottinghamshire LMC chair Dr Greg Place said: ‘Well it would of course [take more GPs out of sessions] as GPs might be really good at multitasking but this does require a degree of focus and commitment which would mean some time out of mainstream general practice.’

Dr Chris Udenze, a former principle single-handed GP in Nottingham who now works in London, said: ‘I think it will have some sort of small additional impact on workforce availability to frontline work. The East Midlands has got [one of] the highest GP trainee vacancy [rates] in the country. Maybe the CCG needs to look at why Nottingham is perceived as a very hostile environment for GPs – which it is.

‘Nottingham has been so prominent in harassing single-handed GPs out of practice, which hasn’t helped with GP availability and patient choice. This is yet another reorganisation that sounds like a good idea but has not really been thought through clearly at all.’

Dr Jonathan Harte, one of Nottingham City’s PCNs clinical directors, suggested all the networks would ‘benefit’ from having deputies, given the ‘intense’ workload in general practice.  

He said: ‘I think all PCNs would benefit from having a deputy. The workload has been intense the last two months – so rather frustrating that funding for clinical directors only started two days ago – the number of meetings required is huge and as GPs we also have day jobs so can’t get to everything.’

The role of the clinical director

When the new five-year GP contract was released in January, NHS England announced that all networks must appoint an accountable clinical director, who will be responsible for ensuring the delivery of local services, by 15 May, but there was no mention of a deputy clinical director.

This comes after NHS England said the networks will have to succeed in convincing a new generation of GPs to go into partnerships or face becoming ‘salaried to other NHS providers’.

This week, the RCGP warned that there is no ‘one-size-fits-all’ solution to address the issues general practice currently faces, pointing out that some practices part of a PCN will need more resources than others to grow further

Meanwhile, GP leaders warned that some practices have ‘hurriedly’ designed their networks, which might later lead to ‘contentious issues’.