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Networks are open to manipulation

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The English contract was announced in January, yet we are learning more and more about it every day.

This week, Pulse has revealed that networks – the groups of 30,000-50,00 patients – will not have to have a clinician lead. But, more importantly, there are suggestions that CCGs are trying to manipulate the networks to fit in with their own plans.

The problem is, this is not a surprise at all. CCGs are the arbiter of what constitutes a network. And they are the ones ultimately accountable to NHS England. So it stands to reason that there will be some that will want to impose a structure on practices.

It wasn’t meant to be this way – networks are supposed to be GP-led. But the very nature of them means that this is open to manipulation.

In balance, I still think that the new contract will lead to improvements in general practice. But I can imagine we will find some more unwanted surprises as the months go on.

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