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NHS England pledges to change network proposals after ‘significant’ GP concerns


NHS England will ‘significantly’ redesign the primary care network (PCN) service proposals after over 4,000 GPs voiced concerns over the networks’ ability to deliver the specifications.

The network proposals, revealed in a draft document on 23 December, caused anger among the profession when it was announced that GPs would have to carry out ‘at least’ fortnightly care home visits from September.

GP leaders warned the plans were not achievable, due to the increase in workload and lack of additional funding, during a time of a staffing crisis in general practice – and in some regions practices were advised to reject the network DES contract altogether.

This was followed by GPs stepping down from their roles as clinical directors of networks

NHS England has now said it wants to agree a ‘significantly reworked set of service specifications’, with discussion set to be held at the BMA GP Committee meeting on 6 February. 

The consultation received a total of 4,048 responses between 23 December 2019 and 15 January 2020, and more than 200 ‘direct feedback emails’.

In its specification summary report, NHS England said the feedback unearthed ‘clear concerns’ including insufficient funding and the capability of PCNs to deliver the requirements with a shrunk workforce.  

The report said: ‘Whilst there was a level of in-principle support for the aspirations of the individual services, the engagement showed major concerns. These include; the workforce implications and the investment general practice is being asked to make in new workforce roles; the level of resource available to support delivery; the level of specificity and length of the specifications and the aggregate effect of introducing all five services from April 2020.’

It added: ‘We want to provide PCNs with certainty and renewed confidence about their future as rapidly as possible. The feedback has already been informing negotiations on the final GP contract package, which we want to agree as soon as possible with the BMA GPC, addressing the core concerns raised in a way that continues to respect the existing five year deal, sustains general practice, and secures improvements for our communities.

‘The scale and feedback received demands a clear response, in the form of an updated overall contract package, as part of which we want to agree a significantly reworked set of service specifications.’

In a tweet, Berkshire, Buckinghamshire and Oxfordshire LMC chief executive Dr Richard Wood warned NHS England that this might be ‘the last time GPs can pull out of the DES relatively unscathed’.

He said: ‘Does the new spec represent a more realistic long-term goal for PCNs, or have you just adjusted for the short-term? As LMC CEO I need to advise my practices with the long view in mind.’

In response, NHS England director of primary care Dr Nikita Kanani said: ‘Thanks for asking. Of course (some would say) this is a fundamentally different way of working now. Better. More empowering. Realistic and hopeful. GPC will have to decide but I am naturally hopeful.’

The BMA will negotiate and agree on the proposals with NHS England on 6 February.