Total funding available to PCNs through the additional roles reimbursement scheme will hit £891m per year by 2023/24 - with typical 50,000-patient networks set to receive £726,000 towards the cost of social prescribers, clinical pharmacists, physiotherapists, physician associates and paramedics.
But LMCs have warned that the scheme is unfair on innovative practices that invested in staff in these roles before PCNs were rolled out across England.
A motion for debate at the 2019 England LMCs conference on 22 November says that the additional roles reimbursement 'disproportionately disadvantages innovative practices who hired workforce ahead of the scheme'.
It also hits out over 'unrealistic' timescales for recruitment and calls for PCNs to be allowed to retain funding if they are unable to recruit staff.
LMCs are also set to warn that they have ‘no faith’ that PCNs will reduce GP workload, and to debate concerns that the new model for primary care will fail to strengthen a ‘dwindling GP workforce’ - and will debate calls for the GPC to 'reject' PCNs in favour of 'a new GP contract that actually positively supports the current model of English general practice'.
Delegates will also argue that PCN clinical directors need adequate support to ensure the success of networks across England, warning that current expectations were ‘unrealistic’.
The debates come just months after an NHS England document revealed that PCNs that failed to use their funding to recruit to additional roles would lose the money, which would then be given to other networks in their CCG who had been able to recruit.
Senior GPs have warned this approach could increase health inequalities by punishing well-developed PCN areas where additional staff were hired ahead of the scheme. They added that ‘inflexibility’ within the contract - mainly around the roles that PCNs were asked to hire to - prevented networks from tailoring recruitment efforts to their need, preventing the improvement of population health in their area.
LMCs will call for PCN clinical directors to be ‘empowered and supported’ and will warn that current expectations around PCNs are ‘unrealistic’.
LMCs will call for any attempts by commissioners to use clinical directors for the performance management of PCNs and constituent practices, and for clinical directors to be paid for the role they undertake independent of network size - with parental and sickness leave reimbursements made available to them.
Clinical director of Bridlington PCN in Yorkshire Dr Zoe Norris recently told GPonline that she and other PCN leaders were feeling overwhelmed by their new responsibilities - and warned that some could drop out if they did not receive adequate support.
In August, a GPonline opinion poll found that two thirds of GP partners thought that PCNs would fail to achieve any of their key targets set by NHSE, which includes achieving ‘clear and quantified impact for patients’ and the wider NHS.