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Told you so

The BMA is ‘currently in negotiation’ with NHS England to ensure PCNs get the resources they need to deliver network specifications’.

That’s a funny sentence in both senses of the word.

Funny as in hilarious that the BMA has only just realised what they actually signed up to when they mulled over that back-of-the-envelope scribble a while back.

And funny as in odd, now that the PCN contract deal is done and dusted, that they think they can start renegotiating terms.

I’m not trying to be wise after the event: when we were being oversold that bright new PCN future, many of us blogged ad nauseam about how the contract had some terrifying strings attached.

Specifically, those un-magnificent seven service specifications and, in particular, the one about enhanced health in care homes.

Do care homes need better service provision? Yes.

We have officially signed up to being a hostage to fortune

Do we have the capacity to provide vanguard-level care via a hastily assembled troupe of signposters, pharmacists, physios and physician associates? Not unless those additional roles can be melted down into a community geriatrician.

Worse still, we have officially signed up to being a hostage to fortune.

The contract made it crystal clear that the additional roles reimbursement is dependent on fulfilling service specification targets.

The chapters were pretty much headed up ‘Quid’ then ‘Pro quo’.

So we’ve been sold down the river.

And the BMA’s apparent attempt to renegotiate that sale simply confirms that, while we drift into oblivion, they are standing on the riverbank with a belated look of realisation, fear and panic on their faces.

We could have told you this a year ago, BMA, and we did. And that’s not funny, in any sense.

Dr Tony Copperfield is a GP in Essex. Read more of Copperfield’s blogs at or follow him on Twitter @doccopperfield