BMA GP committee chair Dr Richard Vautrey told GPonline that the decision to approve GP at Hand's PCN application 'flies in the face of both the NHS long-term plan and the national GP contract agreement' - and confirmed the committee would seek urgent talks with NHS England.
London GP leaders said they were 'dismayed' at the move. Londonwide LMCs confirmed it had called on the BMA's GP committee to intervene because it believed GP at Hand's proposed PCN 'does not meet the nationally negotiated criteria'.
Documents published last week by Hammersmith and Fulham CCG confirmed that the approval process for PCNs in its area was on hold, in part because it was seeking assurances from NHS England over GP at Hand's bid to form a standalone network.
The CCG said it had sought high-level approval because the GP at Hand registered population of over 50,000 patients is 'dispersed over a significantly larger geographic area than other PCNs'.
The five-year GP contract agreement published earlier this year describes PCNs as ‘the natural unit for integrating most NHS care’. It says that ‘collective general practice can become the footprint on which other NHS community-based services can then dock’ - and crucially that ‘by serving a defined place, the PCN brings a clear geographical locus for improving health and wellbeing and community leadership’.
However, following talks with NHS England, Hammersmith and Fulham CCG told London's GP leaders that it would welcome the GP at Hand bid to form a PCN.
The CCG said: 'Having considered the various criteria for the PCN registration and DES contract requirements, the consensus within north-west London is that the best fit would be for the Babylon GP at Hand practice to consider an application to be its own individual network.
GP at Hand
'This will enable the CCG to ensure maximal compliance with the PCN criteria and meet the needs of the Hammersmith and Fulham patient population and given the unique nature of the Babylon GP at Hand patient distribution and the associated impact this will have on the PCN operating model, this will help ensure the best balance for all of the registered practice populations. The CCG would therefore welcome an application to this effect which would be likely to be endorsed at integrated care system level.'
Dr Vautrey said: 'This proposal flies in the face of both the NHS long-term plan and the national GP contract agreement to focus on and support population based health systems through the development of primary care networks.
'It appears that there is one rule for those serving the more affluent and another rule for the rest of the country and this could, as last week's independent review of GP at Hand suggests, widen health inequalities which is counter to everything the NHS should stand for. We will be discussing this urgently with NHS England.'
A Londonwide LMCs spokesperson said: 'Londonwide LMCs was dismayed to be advised that following discussion with NHS England, Hammersmith and Fulham CCG "would welcome" an application from Babylon GP at Hand to manage a pan-London PCN.
'We remain of the view that the Babylon GP at Hand position does not meet the nationally negotiated criteria regarding the geographical contiguity of these new networks.
'As the contract and PCN criteria were negotiated at a national level between NHS England and GPC, this matter has been formally escalated to GPC for further action. We look to NHS England and GPC, who agreed the new national PCN DES contract and the establishment of PCNs, to consider how such an out-of-specification application should be dealt with. In particular, this must be done with no detriment to practices and their patients.'
A Babylon GP at Hand spokesperson said: 'On behalf of our patients and staff, we are delighted that a Babylon GP at Hand network is being welcomed by commissioners. This is a significant step towards delivering the digital-first aims of the NHS long-term plan.'
GP practices across England had until 15 May to submit applications to form PCNs, with all patients in England expected to be covered by one of the networks by July.