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To engage or not to engage…?

Please note – we are pre-moderating comments on this. We should have made this explicit when this was first published and I apologise for not doing so, especially as it was over the weekend. We are more than happy to publish criticism of the policies, but there have been personal attacks in the past, which we cannot tolerate. Your comments will be published ASAP. Jaimie (editor)


Over the past month we have seen frustration and concern over the draft primary care network (PCN) service specifications that were being engaged on.

When we first published ‘Investment and Evolution’ last year, we committed to both sustaining general practice and improving the quality of care. We knew this was going to be a tough ask.

Yet we also know that general practice has been struggling. Too many people are leaving the profession and too many doctors report burnout or compassion fatigue. And we have to acknowledge that satisfaction by our patients with access to their GP practices has also been eroding.

The move to supporting practices – large or small – through working within PCNs is the beginning of addressing this. Bringing in more staff. Recruiting more GPs. Creating more of the right type of capacity, so patients are seen by the right person.

PCNs are also intended to be a way of offering better health and care. Locally joined up services, offering evidenced based improvements for patients, designed through seven service specifications, delivering the improvements set out in the long term plan.

The first five of these were published for engagement in late December. Having been unable to publish during the election we wanted to get your views, reflect on them and agree the overall deal with the GPC so that we can make the necessary payment system changes in time for 1st April.

The draft specifications will indeed change before they are finalised

We needed to get the specifications right for the profession and for the public. The first draft was never going to be the last word and we needed your help to get them right.

There was a lot in the draft specification document. It is clear that some felt it was overly prescriptive, or that too much was being asked of GPs. Some may even have felt that this was not what they expected from PCNs.

Many thought that the aspirations of the individual specifications were sound but were cautious of the implied performance management.

Here, we’ve summarised the feedback we received – from over 4,000 respondents (mainly GPs, PCNs and LMCs), and through webinars and twitter chats.

We wanted feedback and we got plenty. We’ve worked through every response. You’ve given us a clear message, so the draft specifications will indeed change before they are finalised.

The themes in the feedback document are informing our discussions with the BMA’s GP Committee. We hope you will find them realistic, workable and fundamentally supportive of general practice, the partnership model and primary care networks – as well as good for our patients.

I want to thank all those who gave up precious time to take part. This is the first time we have engaged in this way and we hope that once you see the outcome of this process you can see we are genuinely trying to get this right.

Dr Nikki Kanani is medical director of primary care for NHS England and NHS Improvement