PCNs are 'existential threat' to GP independent contractor model, BMA warns

The BMA's England GP committee has warned that PCNs pose an 'existential threat' to the independent contractor model of general practice - but rejected calls to form a separate subgroup to represent partners.

Dr Farah Jameel
BMA GP committee chair Dr Farah Jameel (Photo: BMA)

At a meeting on 19 May, the BMA England GP committee affirmed its support for a motion passed at last November's England LMCs conference warning that PCNs pose an existential threat to the independent contractor model.

The committee also voted to confirm its commitment to the independent contractor model - just weeks after GPonline reported on a draft letter from LMCs warning that the profession's leaders were overseeing its 'slow death'. The letter warned that GP leaders in England had failed to articulate a clear strategy and vision to protect the independent contractor model of general practice.

The committee also highlighted concerns over the 'deteriorating working conditions' of GP partners across the country - as a shrinking workforce struggles to manage soaring workload.

GP partners

However, the BMA England GP committee rejected a motion calling for it to 'pursue a change to BMA articles and byelaws to allow the formation of a separate GP contract-holders committee'.

Criticism of PCNs by the GP committee comes after NHS England imposed changes to the GP contract for 2022/23 that increase workload linked to networks. An indicative ballot of GP practices by the BMA last year found that more than half of practices would be prepared to opt out of PCNs - and the BMA has faced criticism for not pressing ahead with industrial action.

The vote against a separate committee for partners comes despite backing at the UK LMCs conference earlier this month for a separate committee to represent partners. GPs at the conference in York voted narrowly in favour of a motion that called for the BMA's GP committee to form a separate 'contract holders subcommittee to represent and discuss GP partnership contract issues'.

The motion was passed only as a 'reference' - meaning it does not become official conference policy, but requires GP leaders to consider the spirit of the motion and bear it in mind in future negotiations.

BMA England GP committee chair Dr Farah Jameel said: 'General practice has evolved over many years, changing to meet the needs of communities, but with the independent contractor model sustaining as the core on which it is built.

Independent contractors

'We know that patients appear to benefit from continuity of care, with the quality, strength and consistency of their relationship with their family doctor having a significant impact on their health outcomes. All of this and more is possible through the independent contractor model.

'The outcome of this motion reaffirms the committee’s wholehearted support and commitment to this model that allows for high-quality, cost effective and timely care, despite it being poorly valued by policymakers.'

Alongside calls for a separate committee to represent GP partners, the UK LMCs conference this month heard from sessional GP committee chair Dr Ben Molyneux that he had applied for sessionals to become a separate branch of practice within the BMA, with independent negotiating powers, over concerns that sessional GPs are not adequately represented within the current structure.

Dr Jameel said the vote 'demonstrates how important it is that the profession stands together with strong representation for all GPs, regardless of career path, at a time when general practice and the whole of the NHS and care system are facing unprecedented challenges'.

Motion debated by BMA England GP committee in full:

That this committee:

i) Reaffirms its commitments to the GP independent contractor model and renews its efforts to supporting the model. PASSED

ii) Recognises the deteriorating working conditions of GP contractors throughout the country. PASSED

iii) Will pursue a change to BMA articles and byelaws to allow the formation of a separate GP contract-holders committee. FELL

iv) Rejects NHS England's approach in replacing General Practice with a one-size model all-salaried service. PASSED

v) Reaffirms the belief (as also expressed by Conference) that PCNs pose an existential threat to the independent contractor model. PASSED

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