GPs warn of 'chaos' as PCN registration deadline looms

Delayed guidance, increased workload and a lack of up-front funding have left GPs 'scrambling in the dark' to meet the primary care network (PCN) registration deadline.

PCN deadlines looming (Photo: Universal Images Group/Getty Images)
PCN deadlines looming (Photo: Universal Images Group/Getty Images)

GPs involved in setting up PCNs have warned that setting up the networks has landed significant extra workload on practices that are already under pressure - with no network funding due until July.

Meanwhile, with just 10 days left until PCNs become operational, NHS England has yet to publish a template data sharing agreement that all GP practices are expected to review and sign by 30 June.

The network contract DES specification, published in April, states that all GP practices within a PCN must have in place by 30 June 2019 ‘appropriate data sharing arrangements and, if required, data processor arrangements (both using the template to be provided) that are compliant with data protection legislation to support the delivery of extended hours access services’.

Data sharing template

GPC sessional subcommittee chair Dr Zoe Norris - who is set to take on the role of clinical director at her local network in Bridlington, Yorkshire - told GPonline that the timelines for PCN formation were ‘spectacularly tight’, with GPs still waiting for NHS England’s data sharing template.

‘The delays in guidance from lots of organisations are a challenge for all PCNs,’ Dr Norris said. ‘We are all still doing the day job alongside trying to get things set up, and we are GPs, not legal, finance or GDPR experts.

‘We are trying to hang on until the official [data sharing] guidance comes out purely to avoid the pitfalls of starting something and then the advice changing. We simply don't have the time or funding to do this twice.’

Other PCNs are understood to have set up their own agreements - which could have to be updated quickly when official guidance emerges.

Primary care networks

‘All the timelines have been spectacularly tight for PCN formation, and it has felt very chaotic,’ Dr Norris said. ‘This means that a lot of PCNs are having to do their best, and hope that NHS England act in good faith until things are finalised. That's quite a big ask for a profession that hasn't felt valued for a number of years.’

Speaking at a Westminster Health Forum event earlier this month, NHS England’s deputy medical director of primary care Dr Raj Patel assured delegates that the data sharing agreement template was ‘in development’. An NHS England spokesperson has since told GPonline that the template ‘will be published very soon, but no date has been fixed’.

BMA GP committee chair Dr Richard Vautrey has also said he expects it to be published before the end of June.

Increased workload has also proved difficult for GPs involved in setting up PCNs. ‘The main challenge so far has been trying to get the time and headspace to keep everyone up to date and on board,’ Dr Norris said. ‘It would have been really helpful for a chunk of the DES funding to have been paid through to all PCNs who met the 15 May deadline [for submitting PCN applications].’

GP workload

This would have helped ‘free up clinicians and practice managers to do the paperwork, talk to colleagues, and attend the millions of meetings that have suddenly popped up', she said.

Dr Norris’ words echo the findings of GPonline’s latest opinion survey, which showed that half of GP partners think PCNs will increase workload for practices. One GP taking part in the survey said: ‘There's never remuneration for attending these meetings or for the time taken with all the reading. It's just another level of administration and increasing complexity.’

An NHS England spokesperson said: ‘We can only pay primary care networks once they are confirmed and signed up to the DES, which means there is inevitably some lag between them doing work to set up and receiving payment for being set up.

‘However, to reflect this the network participation payment is paid from July but backdated to April to reflect the work which will have been done between April and July to set up.’

Despite the problems, Dr Norris says she is ‘cautiously optimistic’ about PCNs, adding: ‘Everyone is scrambling in the dark, so there's no right or wrong way of doing most of it. But that there is huge potential if PCNs are allowed to do what we have all been told and let general practice lead on patient care. NHS England has to continue to empower PCNs and clinical directors to do what is right for their patients, and CCGs have to support this.

‘In areas with supportive CCGs like ours, it's a really exciting chance to get funding where it needs to be and offer truly tailored care for our patients. I'm really excited about the impact some of our schemes can have on our most complex patients.’

Practices will receive funding for participating in a PCN through the network participation payment of £0.147 per weighted patient for the period from 1 April 2019, NHS England says. This becomes payable once practices have signed up to the Network Contract DES and the DES commences, from 1 July 2019. Once established, PCNs are entitled to funding of an additional £0.125 per patient per month from CCG allocations, the first payment of which will cover the period 1 April to 31 July.

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