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Pulse revealed this week that less than half of the money for the additional roles reimbursement scheme for PCNs had been spent last year.

This is significant. Among all the incentives on offer for PCNs, this was the biggest and offered up the most funding. As with all data like this, there are caveats. A lot of that funding would have been held over for this year, or spent on other PCN activities.

But the fact is that the offer of pharmacists and social prescribers last year (along with the array of roles on offer this year) does not equate to straight funding. If you can’t find a pharmacist, tough luck – you just better hope you have a benevolent CCG that takes NHS England’s voluntary advice to retain the funding in general practice. And if you don’t need a social prescriber (or any other non-GP healthcare professional), or feel it is more hassle than it is worth to find and train them? Again, too bad.

There remains no reason why the health authorities can’t just trust GPs to spend the money as they see fit. Contrary to the belief of the reactionary press, it won’t go straight into GPs’ pockets. GPs want to reduce their workload more than anyone, and reducing GPs’ workload is the one thing that would improve patient care more than anything. But sadly, this is a much harder case to make to the electorate.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at


Simon Gilbert 7 October, 2020 4:03 pm

There seems to be a commissioning cognitive dissonance between the ideas that much of secondary and mental health care can be decommissioned and dumped to general practice (much of which has already happened) without any loss of quality or increase in risk vs the idea that no new money can go to primary care unless it is accompanied by a requirement for extra (often inappropriate) work and more process targets.

David OHagan 9 October, 2020 11:07 am

The now old chant was ‘its in the global sum’.
Now ‘its in the PCN funding’.
Money is even less available for practices,
for the services that patients want, or for the services that patients need.

CCGs have not had control of their budgets for 6 mths now,
and will not have for the next 6.
CCGs could be doing more to adapt local systems to local needs.
CCGs are using their connections with local communities, local authorities PCNs and local providers, but the ‘big chiefs’ take too much waking up.
2020 style ‘Command and control’ is not flexible enough or ‘skirmish ready’.

Andrew Jackson 9 October, 2020 4:08 pm

The whole thing is a disaster but we shouldn’t be employing people on unsustainable contracts because of a shortage of applicants
we shouldn’t be allowed to go above the agreed limit
the best primary care jobs are being negotiated by many of these practitioners when the whole point of it was to save general practice from the exodus of Drs due to workload

David Turner 10 October, 2020 1:04 pm

Too true.
It is the usual story, money available but not available to spend on what you actually need; more GPs/nurse practitioners/community nurses. i.e. health care professionals to knuckle down and do more of the day job on the front line.
No it always has to be something new and shiny which you usually don’t particularly need.

Christopher Ho 14 October, 2020 10:38 am

“2020 style ‘Command and control’ is not flexible enough or ‘skirmish ready’.”

That has long been the case — Big govt sucks… and can never be as responsive or malleable as free market forces.

“money available but not available to spend”

??? Last I checked, we are in growing debt and deficit. If you’re happy to pay more tax David, or have your children pay more tax, by all means you’re free to do so right now, but that might not be the case for all….