GP leaders to debate PCN DES boycott over 'existential threat' to practices

Primary care networks (PCNs) are a 'Trojan Horse' set up to dump hospital work on practices and GPs should reject the network DES, GP leaders will argue at a special LMCs conference this month.

LMC vote (Photo: JH Lancy)
LMC vote (Photo: JH Lancy)

Motions tabled for debate by LMCs at the 11 March conference make clear the deep reservations that remain in the profession over not just PCNs, but the entire five-year GP contract that began in April 2019.

The special conference - just the third LMC gathering of its kind this millennium - was convened after the BMA's GP committee rejected a package of contract proposals including a version of the controversial network DES put out for consultation over Christmas and the New Year.

The committee later backed a revised contract offer after major concessions on the network DES that saw the agreement of 100% funding for staff brought into additional roles through PCNs and reduced requirements for the networks in 2020/21.

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Summary of changes to the GP contract 2020

However, GPs have continued to express reservations over the DES - and GP leaders will now debate calls to 'reject the PCN DES' in its current form, as part of a motion warning that PCNs pose an 'existential threat' to the future of the GP independent contractor model.

The motion says PCNs are being used as 'Trojan Horse' to transfer hospital work to practices, and calls for the 'immediate cessation' of the transfer of responsibilty for local and directed enhanced services from practices to PCNs, and for investment in core services.

GPs will also debate warnings that PCNs still face a 'significant funding gap' and that the £120 per care home bed fee agreed under the enhanced care in care homes specification for PCNs does not fully reflect the workload involved.

The conference will also debate a claim that the five-year GP contract was 'mis-sold' - and is in fact a one-year deal - and will hear criticism of the BMA's GP committee for agreeing the 2020 contract before the special conference had the opportunity to debate the deal.

LMCs will also warn that plans to publish the names of doctors earning more than £150,000 a year will undermine recruitment of GP partners and could drive some to reduce their working hours.

GP partners

The conference will also hear calls for an expansion of the £20,000 golden hello scheme for new partners under the 2020 contract to cover GPs who have previously held partnership roles - and for the payment to be tax-free. LMCs will also call for these golden hellos - which will initially be paid as a loan - to become a permanent payment after three years of service rather than a possible five-year term proposed in the 2020 contract agreement.

Warnings over incentives for GP partners come just days after GPonline reported that general practice in England lost almost 1,000 full-time equivalent (FTE) partners in the 12 months to December 2019 - and that thousands more are close to retirement.

GP leaders will also warn that practices must retain the right to remain outside PCNs without being penalised financially. One motion warns that there must be a 'genuine financially viable option' for practices that decline to sign up to the network DES in future.

The motion - put forward by Cleveland LMC - warns that involvement in PCNs must never become a 'core GMS requirement' for practices and that 'a clear demarcation between core GMS services and enhanced services including the PCN DES'.

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