NHS England has said it is considering the deferral of the four new PCN service specifications that were due to start in October.
And the ‘main implementation focus’ of the PCN investment and impact fund (IIF) should be deferred a year, although NHS England must ‘honour the existing commitment’ of expanding the funding this year, it added.
In a letter seen by Pulse, NHS England also invited the BMA to return to formal meetings – which have been paused since May due to a row over suggestions that practices were closed.
The BMA welcomed NHS England’s ‘change in tone’ and said it was keen to ‘build on’ the progress so the organisations can ‘both reform [their] working relationship’.
It comes as a ‘constructive’ meeting between the BMA and NHS England’s new chief executive Amanda Pritchard last week failed to bring GPs back to negotiations.
The letter, sent yesterday, set out NHS England measures for ‘supporting general practice’ amid the ‘intense’ pressures on GPs and ‘very real workload challenges being experienced’.
It said: ‘As we plan for autumn and winter against this challenging backdrop, we have heard the call by GPC England for different phasing of new PCN service specifications.
‘In our meeting, we described how NHS England is looking again at whether certain of these can be deferred from this October until no later than April 2022, bearing in mind the renewed urgency of tackling healthcare inequalities for example in hypertension detection, working in tandem with our community pharmacy partners.’
It added that the ‘main implementation focus’ of the PCN IIF should be 2022/23 rather than 2021/22 so that PCNs have the ‘maximum possible time to prepare’ in light of ‘immediate pressures’.
However, NHS England ‘must also honour the existing commitment to expanding the 2021/22 fund up to the £150 million of promised available funding as a lead-in to the £225 million 2022/23 fund’, as well as ‘provide clarity’ on both this and next year’s IIF ‘as soon as possible’, it said.
Meanwhile, the letter said NHS England ‘stands ready to resume working’ with the BMA’s GP negotiators ‘as soon as [they] may be able’.
Writing to BMA GPC chair Dr Richard Vautrey, NHS England national director for primary care Ian Dodge said: ‘Amanda and I affirmed the value we place on our relationship and dialogue with you and GPC England.
‘We have shared objectives of supporting the sustainability of general practice and improving services and outcomes for patients. The primary care team here stands ready to resume working with you, including on PCN extended access arrangements, as soon as you may be able.’
Responding to the letter, Dr Vautrey said: ‘Following the constructive meeting with the newly appointed NHSE chief executive Amanda Pritchard last week, these are further welcome steps from NHS England, and suggests a change in tone, understanding and approach.
‘We are keen to build on this and turn this into positive action so we can both reform our working relationship and work together for the good of practices and our patients.’
NHS England’s letter also said that PCNs ‘struggling’ with recruitment and retention need ‘additional support’ from CCGs and ICSs and that there is a need to ‘reinvigorate’ GP recruitment and retention schemes.
It said: ‘Expanding workforce capacity in general practice is more vital than ever before, and we want to work with GPC England to achieve this.’
It added that the positive results of the NHS’s latest GP patient survey are an ‘objective testimony to the dedication and professionalism’ of practice teams.
NHS England said: ‘They reflect how well the majority of practices have been able to adapt and innovate during the pandemic, maintaining and improving access.
‘[And] they reinforce the need to hold onto what has worked better for professionals and patients alike as we continue to learn together about how best to combine different modes of online, telephone and face-to-face access.’
It also recognised that general practice is ‘working harder than at any other time in its history’, including providing more non-vaccine appointments than pre-pandemic while delivering the ‘lion’s share’ of Covid jabs.
Dr Vautrey said it is ‘encouraging’ to see practice teams’ ‘immensely hard’ work ‘acknowledged’ by NHS England.
A new report revealed this month that almost nine in 10 PCN leaders do not want any new network service specifications to be implemented this year.
Four extra PCN services – covering CVD diagnosis and prevention, tackling inequalities and the controversial personalised care and anticipatory care services – were due to be brought in as early as October.
But last month the BMA revealed it had met with health minister Jo Churchill, urging her to delay the four upcoming PCN services this autumn until April 2022 over workload concerns.
Meanwhile, the BMA’s annual representatives’ meeting (ARM) is set to debate NHS England’s ‘negative briefings’ suggesting GP practices were ‘shut’ during the pandemic.