NHS bosses to rethink 'what can realistically be delivered by PCNs'

NHS England has promised to consider 'what can realistically be delivered' by primary care networks (PCNs) after 'large numbers of GPs' submitted feedback on draft network DES specifications in the first-ever public consultation on a part of the GP contract.

NHS England chief executive Sir Simon Stevens (Photo: Alex Deverill)
NHS England chief executive Sir Simon Stevens (Photo: Alex Deverill)

In a statement published last week after a short consultation on draft specifications for the network DES closed, NHS England said 'huge thanks are due to the large numbers of GPs, LMCs and others who have taken the time to read and respond to the drafts'.

It admitted the consultation - which ran from just before Christmas to 15 January was 'necessarily shorter than planned' because of the timing of the general election and 'the need to give GPs good notice of their new contracts for April 2020.

The consultation process marked the first time that the profession as a whole had ever been offered the chance to provide feedback on draft GP contract plans - and NHS England said 'whatever the views of respondents about the specifications, we view such widespread engagement in a debate about how PCNs develop as a positive change and a learning opportunity'.

Stabilising general practice

NHS England's statement adds: 'We want to be absolutely clear that we have heard the views expressed. We will now carefully consider how to respond adequately, balancing the ambition to improve services for patients across England and the need to stabilise general practice, with what can realistically be delivered by PCNs in 2020/21.'

It said analysis of responses has already begun and that a final version of the network DES requirements 'will now be agreed as soon as possible through negotiations' with the BMA's GP committee'.

However, the future of the £1.8bn PCN programme - a core element of the five-year GP contract that took effect from April 2019 and of the NHS long-term plan - has been left in serious doubt by the strength of GPs' response to the draft proposals.

Senior GPs in leadership roles within PCNs have quit or threatened to pull out, some LMCs have urged doctors not to sign the contract unless changes are made - and last week the BMA's GP committee voted to hold an emergency conference once contract talks between its executive committee and NHS bosses are complete.

GP contract

GP leaders in the BMA voted last week to reject completely a package of contract measures proposed for April 2020 - including the controversial network DES plans, but also wider measures planned for introduction through the core contract.

An overwhelming 80% of GP representatives are understood to have rejected the contract plans on the table - and following the vote, BMA GP committee England chair Dr Richard Vautrey said: 'The message from GPs in recent weeks has been a clear one: proposals put forward by NHS England and Improvement before Christmas have clearly been judged by the profession as unreasonable, and completely unachievable.'

The BMA special conference will consider all proposed changes to the GP contract from April 2020. Beyond the network DES proposals, details of contract changes rejected by GP leaders remain confidential. But changes expected from April 2020 under the five-year agreement include all practices providing online consultations, changes to the QOF around heart failure, asthma and COPD - and a 2.3% uplift to core pay. 

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