RCGP warns of 'clear risk PCNs will fail' amid calls for fresh start on DES plans

The RCGP has called for a complete rethink on draft network DES plans, warning that in their current form there is a 'clear risk primary care networks (PCNs) will fail' and that existing GP services will be undermined.

Professor Martin Marshall (Photo: Pete Hill)
Professor Martin Marshall (Photo: Pete Hill)

In a letter to NHS England chief executive Sir Simon Stevens, RCGP chair Professor Martin Marshall said the college backed the creation of PCNs - but warned that controversial draft service specifications published in December threaten to 'destabilise services in some areas'.

Following widespread concern across general practice - with warnings that the plans could add significantly to GP workload and cost practices more than £100,000 per year on average - Professor Marshall said the college recommended 'beginning the process again for developing the specifications'.

His intervention came as speculation emerged that NHS England could be ready to row back from the draft proposals.

NHS England director of primary care and system transformation Matt Neligan wrote on Twitter this week that there had been 'lots of feedback to date that tells us we need to make changes', adding that NHS England was 'committed to doing just that'.

Meanwhile, sources within NHS England have suggested that two of five draft specifications set to take effect from April 2020 could be ditched, according to the Health Service Journal. The sources said specifications on anticipatory care and personalised care could be dropped, with a draft specification on care homes pared back to reduce demands for visits.

An NHS spokesperson would not confirm the comments, warning it was too early to speculate about the final version of the DES specifications. Consultation on the draft plans ends today, and contract talks between the BMA and NHS England will follow.

Primary care networks

The BMA also said it could not comment on speculation that NHS England was ready to row back from demands on PCNs set out in the draft plans.

In the letter to NHS England's chief executive, Professor Marshall said the lack of opportunity for frontline clinicians to help shape the plans for PCNs 'puts the profession's trust PCNs at risk' - adding that 'unrealistic expectations and timescales' in the plans 'risk squandering the goodwill' built up between GPs and NHS England over the past year.

He warned the current proposals were 'overly prescriptive' and 'will inevitably impact on practices' abiltiy to maintain the accessibilty and services they are currently providing and take away the freedom for professionals to truly improve care for their patients'.

The NHS England spokesperson said: 'Patients are keen to see further improvements in their highly valued local GP services, and taxpayers are backing these with extra funding in line with the contract GPs agreed in January 2019. Discussions on the phasing of these improvements are well under way with a view to agreeing the final contract for 2020/21.'

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