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NHSE official admits ‘we need to make changes’ to draft network specifications



An NHS England official has admitted changes to its proposed primary care network (PCN) DES contract are needed to ensure practices can deliver new service specifications.

NHS England director of primary care and system transformation Matt Neligan acknowledged there had been ‘lots of feedback’ on the service specifications so far and that NHS England was ‘committed’ to revising the plans.

He said NHS England needed to take both the strength of feeling among GPs – and the specifics about the content of the proposals – ‘seriously’.

In a separate webinar held today (Tuesday), NHS England hinted at a roll back on the care home specification, saying that the intention is that enhanced care home is provided by the multidisciplinary team rather than GPs as individual practitioners, referring to the fact that advanced nurse practitioners already visit those patients.

Mr Neligan said ‘we cannot afford’ to make the plans ‘over-ambitious,’ but also warned the additional £4.5bn of funding being provided as part of the NHS long-term plan ‘should create room to do more’.

He urged GPs to share any concerns they have about the current specifications, including whether they think the timetable is realistic.

NHS England director of primary care Dr Nikita Kanani also reassured GPs that feedback will form the basis of the final DES contract requirements.

She tweeted: ‘Everyone is working flat out to process responses so we can rethink and rework as quickly as possible, so the profession isn’t left wondering what’s happening.’

The network proposals, revealed in a draft document published on 23 December, are currently subject to an open consultation, due to close today.

PCNs and LMCs are recommending GP practices not to sign up for the network contract DES in 2020 as it stands due to the ‘overwhelming clinical and financial burdens’ it would place on GPs.

In a series of tweets this week, Mr Neligan wrote: ‘Last couple of days to comment on the PCN services specs. Lots of feedback to date that tells us we need to make changes. We are committed to doing just that.

‘There are some really important points about this work: these are draft and this is a proper, comprehensive and dynamic engagement exercise, being conducted “at scale”. The feedback that we get will influence the final versions that we negotiate.’

He added: ‘We cannot afford to make them over-ambitious: we would like PCNs to welcome the final versions as sensible expressions of ambition.

‘Clinical directors and general practice teams should feel the final versions are deliverable and that they are aimed at the right areas

‘Equally we cannot afford to make them under-ambitious: the £4.5bn going into primary and community care in the NHS long-term plan should create room to do more and these specifications reflect part of that ambition.’

The specifications first drew criticism when it was announced that GPs in networks would have to carry out fortnightly care home visits in 2020/21.

This was followed by resignations of PCN clinical directors across the country.

In addition, a Pulse survey found that 80% of partners will refuse to sign the network DES contract if proposals go ahead.