PCNs could be 'default' option for maintaining GP services when practices collapse

Primary care networks (PCNs) could become the 'default' choice for maintaining services when GP practices collapse or when a new practice is required, NHS England has suggested.

Medical centre (Photo: mtreasure/Getty Images)
Medical centre (Photo: mtreasure/Getty Images)

A document on the future of digital-first primary care published by NHS England says that under potential new procurement rules 'we could remove the need for most local APMS procurements by
looking to PCNs as the default mechanism for maintaining primary care provision'.

But a senior member of the BMA's GP committee told GPonline that 'dumping' additional responsibilities on PCNs risked overwhelming GPs and driving them away.

Documents published alongside the procurement plans last week revealed that NHS leaders also plan to make PCNs responsible for stabilising the GP partnership model - a huge task given numbers of GP partners in England have dropped by more than 3,000 over the past three years alone.

NHS procurement

NHS England's procurement proposals explain that the health service 'could increasingly look to PCNs as the default to maintain or expand primary care provision'. The document says NHS leaders are 'looking to simplify procurement processes as far as possible' - and an accompanying consultation asks whether 'PCNs could become the default means to maintain primary care provision, thus removing the need for most local APMS procurements'.

GPC member Dr Fay Wilson said the proposals were an example of 'sloppy thinking' by NHS leaders. 'The legal mechanism would have to be that the PCN divvies up [an at-risk] practice between the other practices in the area. In some areas that will be welcome - in others where people are already on their knees, it will not.

'This is just really a way of the NHS dumping a responsibility that currently sits with CCGs on thinly-resourced networks of GP practices.'

Dr Wilson argued that making PCNs the 'default choice' was wrong - although offering them first refusal on taking over a struggling practice in their area or setting up a new one might be acceptable.

GP workload

She added: 'PCNs started off with quite a well-defined remit, but seem to be taking on more and more. I think if GPs feel overwhelmed people will walk away from them.'

Dr Wilson said that PCN leaders should be encouraged to 'focus on the original job that it says on the tin'. She said: 'What we need is support systems for local practices. If that is what PCNs are going to be, good - let's focus on that.'

The vast majority of GP practices across England have now joined PCNs, which became operational from 1 July. Just 70 practices - around 1% of the total nationwide - had either opted out or been unable to join a network by last week, official figures showed.

A total of 1,259 PCNs have been set up, and the organisations will be backed by £1.8bn in funding through the five-year GP contract agreement published earlier this year.

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