A committee paper published this week by Hammersmith and Fulham CCG said it had been unable to confirm any of five proposed primary care networks (PCNs) in its patch.
The CCG is seeking assurances from NHS England over whether it can approve plans put forward by GP at Hand, because the service's registered population of over 50,000 patients is 'dispersed over a significantly larger geographic area than other PCNs'.
GPonline reported earlier this month that GP at Hand was applying to form a standalone PCN - but that it may offer other practices the chance to join. A CCG spokesperson confirmed that one further practice was included in the GP at Hand application.
Primary care networks
PCN plans in Hammersmith and Fulham are also being held up because four practices with a combined patient population of just over 16,000 are not included in any of the five proposed PCNs in the area. Guidance set out in the five-year GP contract agreement published in January made clear that CCGs must confirm all primary care networks 'at the same time' to ensure that all practices are included and that the full geographical footprint of the CCG is covered.
Meanwhile, one proposed PCN in the area has named a federation as the organisation that it would like to receive funding on behalf of member practices - an arrangement not allowed under current rules, which state the recipient of PCN funding must hold an APMS, PMS or GMS contract.
Babylon medical director Dr Matthew Noble said GP at Hand would 'continue to work with commissioners, community providers and other proposed networks' to resolve problems around the 16,000 patients not covered by a PCN.
He added: 'Regarding the specific additional issue raised around the Babylon GP at Hand geography, by far the most important consideration for any network is that it benefits its patients. As the more than 50,000 patients who have specifically chosen Babylon GP at Hand live and work across London, it is far better that the network they belong to operates across the capital.'
However, Londonwide LMCs chief executive Dr Michelle Drage said that in the view of the LMCs' organisation, GP at Hand's proposed PCN 'does not meet the nationally negotiated criteria'.
She added: 'We look to NHS England and the BMA's GP committee, who jointly negotiated the new national PCN DES contract and the establishment of PCNs, to agree how such an out of specification application should be dealt with. In particular, this must be done with no detriment to practices, and their patients, who most definitely do meet the nationally negotiated criteria.
'Delays to the PCN sign-off process (potentially until July) will cost time, money, morale, and potentially staff as the unapproved networks are unable to recruit, draw down funds or put measures in place to prepare for these significant changes.
'Both the local LMC and Londonwide LMCs will continue to work within our remit of supporting practices in Hammersmith and Fulham by working with them via the PCNs they have formed, or to consider how non PCN practices might work with those PCNs, and with the CCG.'