Under proposals put forward by NHS England, PCNs could become the 'default' option for maintaining primary care provision when a practice plans to hand back its contract or when an area needs a new practice.
GPs have raised concerns that not all PCNs would be willing or able to take on this responsibility, warning that 'dumping' additional responsibilities on PCNs risked overwhelming GPs and driving them away.
However, National Association of Primary Care (NAPC) president Dr Johnny Marshall told GPonline he was confident that PCNs would be able to maintain services when GP practices fail - provided they receive the correct form of support.
NHS funding
Dr Marshall said financial support delivered though a national incentive scheme would not necessarily guarantee the type of support PCNs would need, urging NHS England to assess cases individually.
‘Whenever you are stepping in to provide an alternative or provide a solution, with that comes a lot of effort and time and it comes with some risk.
‘In some situations, ensuring you have some financial support to enable you to do that, as recognition that someone is going to have to pick this up, is a good thing and I think that should be made available to PCNs to be able to do that.
‘But it won’t be the only thing they need. Understanding what the enabler is at a local level is important, and if it's finances, it should be provided. However, it could actually be in terms of development, capacity or capability [that PCNs need support].’
Incentive scheme
Dr Marshall, who became NAPC president in September and has previously served as NAPC chair, said a national incentive scheme 'could create as many problems as it solved' if PCNs were unsupported in other areas.
‘Sometimes people throw money at stuff because that’s the easy thing to do, without actually recognising that they haven't developed the capacity, capability or time to be able to do this. It’s fine giving people money, but if there is no locum to draw on to free you up, you can’t really effect any change.
‘It has to be a more sophisticated look at what the enablers are. Yes, there will be a financial part of that, but please don’t come up with a national programme that creates these incentives because, if they are not then backed up by all the other elements of support at a local level, you are likely to find that you won’t get such good value for that money.’
In a recent GPonline opinion poll, 60% of GP partners in England disagreed with the plans to make PCNs responsible for maintaing primary care provision when practices fail.
However, the NAPC president said it made sense for PCNs to take on these services when practices failed, adding that some primary care homes (PCHs) - a forerunner of the PCN model backed by the NAPC - that had already started doing this were stronger for it.
‘Part of that is an altruistic thing as part of the population, but part of it is absolutely the practical reality of a situation where the practice next door to you falls over, where are those people going to be cared for? They are going to end up affecting you, so there’s a real business driver to make sure your part of that sort of collective solution.’
