PCNs will fail to deliver any of five core goals set by NHS England, GPs warn

Two thirds of GP partners believe primary care networks (PCNs) will fail to achieve key targets set by NHS England, which include stabilising the GP partnership model and easing pressure on the workforce, a GPonline survey shows.

PCN warning (Photo: Universal Images Group/Getty Images)

A significant 65% of GP partners in England who took part in a GPonline opinion poll said PCNs would not achieve a single one of the five core objectives unveiled by NHS England at its June board meeting.

Meanwhile, over half (55%) of all GPs who responded to the survey - 440 in total - said the networks would be unable to deliver on their core aims, which should be achieved by 2023/24.

Several survey respondents told GPonline they believed PCNs, which came into force in July, would dissuade GPs from becoming partners and create additional workload for GPs rather than reduce it.

Principal targets

The networks, which group neighbouring practices across populations of between 30,000-50,000 people, are intended to strengthen primary care services by encouraging practices to work together and share staff.

In June, NHS England's national director for strategy and innovation Ian Dodge outlined five key ambitions he hoped PCNs would achieve:

  • stabilise the GP partnership model
  • dissolve the divide between primary and community care
  • help solve the capacity gap and improve skill-mix by growing the wider workforce by over 20,000 wholly additional staff
  • become a proven platform for further local NHS investment, including in premises
  • achieve clear quantified impact for patients and the wider NHS

However, a majority of GP partners in England - and a majority of GPs of all types - said PCNs would fail to achieve these targets, casting doubt over the impact of the latest NHS restructure.

GP partnership

Above all, partners believed PCNs would struggle to stabilise the GP partner model, with only one in 10 saying the new measures would be successful.

A similar view was revealed among all GPs surveyed, with just 13% saying PCNs would help to combat a decline that has seen numbers of GP partners in England fall by nearly 3,000 between September 2015 and December 2018.

One GP partner said PCNs would ‘actively discourage’ young GPs from becoming partners; a sentiment echoed by a fellow partner, who labeled the changes ‘very disappointing’.

‘Initially when this was announced I was excited that it may lead to improved patient care. [But] already I feel that it is a mechanism to destabilise partnerships, increase the risk carried by GP partners and prevent new GPs from wishing to undertake partnerships,' the partner said.

Skill mix

GPs were also not convinced that PCNs would help to solve the workforce gap and improve skill-mix by growing a wider workforce - another of NHS England’s core aims.

PCNs are intended to increase the primary care workforce by 20,000 staff including physios, social prescribers, pharmacists and others by 2023/24. But just shy of a quarter (23%) of GPs in England said the networks would achieve this target. Partners were less convinced than GPs overall, with just 14% indicating that the networks would help to reduce capacity and skill deficiencies within practices.

Many respondents said the recruitment of additional primary care professionals was merely a ‘sticking plaster’ solution to the wider issue of GP retention.

One GP said: ‘PCNs are not the solution to the GP recruitment and retention crisis. The directed enhanced service is unlikely to be adequately funded and way more resources will be needed to achieve targets.'

BMA GP committee chair Dr Richard Vautrey said it was unsurprising that some GPs were sceptical about future developments following countless NHS organisational changes in the past.

However, he said the speed at which PCNs had been set up across England underlined GPs' commitment to ‘seize the opportunities’ and make a success of the five-year contract that took effect from April.

‘GPC England has been clear from the outset that the £20bn commitment to the NHS to fund the long-term plan and the £4.5bn contract agreement, which includes the development of PCNs, cannot solve all the problems we face… but they are a step in the right direction.

‘We are very aware that too many people believe PCNs will somehow be able to solve almost every problem the NHS faces but they don't have the capacity or capability to do that and we must manage expectations, giving these new groups time, space and support to develop.'

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