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Practices opting out of DES won’t get ‘better’ contract locally, warns NHSE



Practices that opt out of the network DES will not be able to negotiate ‘better’ local contracts, NHS England has warned.

It comes as GP leaders have advised practices to think twice before signing up to the DES on the basis that it would create unmanageable workload for GPs and their teams.

Two primary care networks (PCNs) have already decided to opt out of the agreement ahead of the 31 May deadline, due to concerns around the workload involved in the service specifications.

However, NHS England’s director for primary care strategy and contracts encouraged GPs to sign up and warned that they wouldn’t find better terms for the same funding through locally-negotiated contracts.

Speaking in a webinar, Ed Waller said: ‘One thing that is important to clarify is that practices who opt out of the DES won’t be able to secure the same services and funding entitlements on better terms via a local agreement. 

‘This is a nationally negotiated DES and to make sure we are fair to everybody, it’s a nationally negotiated set of terms and conditions.’

His deputy Rob Kettell added that practices would have another opportunity to opt out of the DES if ‘substantive’ changes were made.

He said: ‘There are no plans to change the DES. If the DES were to have a substantive variation, then practices would have the opportunity at that point to opt in and out of the varied DES.’

Mr Waller added that the BMA were not consulted on the bringing forward of elements of the DES’s care homes service because there was ‘no need to’.

He said: ‘The DES hasn’t changed and therefore we haven’t consulted the BMA on a change to the DES. There was no need to.’

Meanwhile, he encouraged practices to sign up, saying CCGs would be ‘supportive’ of PCNs delivering ‘as much of the DES as they can’ – rather than ‘resorting immediately to contractual action’.

He said: ‘We’re really clear that the contract management around the DES is going to be supportive and collaborative. 

‘So, we will expect CCGs to focus on the DES itself and the delivery of that rather than the core contract and to look to support practices who are working together in a network to deliver as much of the DES as they can, in the right way, rather than resorting immediately to contractual action.’

NHS England caused controversy when it announced that GPs should start conducting ‘virtual’ weekly care home rounds this month – a ’key component’ of the network DES’s Enhanced Care in Care Homes service.

It later clarified that the ward rounds remain separate to the DES until it begins formally in October, but were being brought forward backed by the Covid support fund.

However, NHS England warned that practices may face regulation if they fail to set up the service – including nominating a clinical lead – by the 15 May deadline.

Last month, Berkshire, Buckinghamshire and Oxfordshire LMCs told practices that they ‘cannot advise signing up for the network DES’ in light of ‘significant concerns’ over its workload requirements.

And Pulse revealed last week that an 85,000-patient PCN in Buckinghamshire and a 40,000-patient network in Milton Keynes have already opted out of the DES – with other PCNs in the regions ‘planning to follow suit’ in the coming weeks.