Doctors tell BMA to pull GP practices out of PCNs by 2023

The BMA has been told to organise the withdrawal of GP practices from PCNs by 2023 in a landmark vote that drives a wedge between doctors and the government over the future of the NHS.

Dr Jackie Applebee

Doctors leaders at the BMA annual representative meeting (ARM) in Brighton backed a motion calling for the withdrawal of practices from PCNs by 2023.

Delegates at the conference also backed a call for PCN funding to be transferred into core funding for general practice, and for the BMA to 'act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contact including industrial action if necessary'.

The 2021 indicative ballot of GP practices in England by the BMA found that more than half would be prepared to opt out of the PCN DES.

PCN withdrawal

The motion passed by the ARM also expressed support for doctors 'fighting to defend the GMS contract' and independent contractor status - following a report earlier this year backed by health and social care secretary Sajid Javid that called for GMS to be scrapped within a decade.

It also voiced support for an motion passed at a 2021 LMCs conference that warned PCNs 'pose an existential threat to independent contractor status'.

The vast majority of GP practices are members of PCNs, but opposition to the networks have been growing, particularly following the imposition of a GP contract for 2022/23 that brought with it significant additional work for general practice linked to PCNs.

BMA GP leaders warned practices they should consider pulling out of PCNs earlier this year in the wake of the imposed contract - but have stopped short of actively calling for practices to withdraw.

GP committee

The ARM vote in favour of withdrawal from PCNs came despite a plea from the leadership of the BMA's GP committee not to 'tie our hands'.

GP committee England deputy chair Dr Kieran Sharrock told the conference that although the LMCs conference voted to warn that PCNs were an existential threat to independent contractor status, many GPs felt PCNs had helped. BMA GP committee England chair Dr Farah Jameel also appealed against passing the vote.

Dr Sharrock said he felt there was not a 'strong appetite' for industrial action at the time of the indicative ballot. However, he told the conference that if 'your mood has changed, we will listen and move'.

Proposing the motion, GPC member and Doctors in Unite chair Dr Jackie Applebee said it was time for GPs to say that 'enough is enough'.

She said it was clear that PCNs were a 'Trojan horse' for privatisation of the NHS and downgrading general practice. She told the conference: 'We cannot keep going on. We are heading for oblivion if we don't have the courage to fight for ourselves.'

BMA representatives backed the motion in a move that raises significant questions over the future of NHS reforms planned by the government and NHS England. The Fuller review published earlier this year set out plans for the evolution of PCNs into 'neighbourhood teams' at the heart of integrated care systems (ICSs), which will become fully operational as CCGs are phased out across England from July.

Read the motion passed at ARM in full:

Motion by LONDON REGIONAL COUNCIL: That this meeting supports GPs fighting to defend the GMS contract and NHS independent contractor status. The long-term GP-patient relationship and the right for GPs to control their workload in a safe way, is essential for the future of general practice. We applaud the South Staffordshire motion passed at the 2021 LMC conference which called for GPC England to negotiate the end of the Primary Care Networks (PCNs) from 2023 as they ‘pose an existential threat to independent contractor status’ and this meeting:
i) calls on GPC England and the BMA to organise the withdrawal of GP practices from the PCNs by 2023;
ii) calls for PCN funding to be moved into the core contract;
iii) instructs GPC England to act upon the GP ballot of 2021 and to organise opposition to the imposition of the new contact including industrial action if necessary.

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