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LMC advises GP practices not to sign network contract DES


By Lea Legraien
9 January 2020

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An LMC has urged GPs not to renew their primary care network (PCN) contract DES this year after deciding the requirements threaten the financial viability of practices.

In a position statement issued today, Berkshire, Buckinghamshire and Oxfordshire LMC said it cannot endorse the PCN DES due to the ‘unrealistic’ requirements laid out in new draft service specifications.

Its chief executives and co-chairs called on practices that are part of a network to pull out of the PCN contract after the LMC assessed they would face a deficit of £100,000 a year from the proposals.

Meanwhile, Nottinghamshire LMC has suggested GP practices in the region ‘will seriously question’ being part of networks in light of the ‘lack of insight into the challenges facing GPs’ displayed in the draft specifications.

Concerns

GPs have expressed major concerns over NHS England’s new proposals for networks, which include the requirement for GPs to carry out fortnightly care home visits.

Practices in PCNs will have deliver five national services from April 2020 onwards, including enhanced care in residential homes and structured medication reviews.

Berkshire, Buckinghamshire and Oxfordshire LMC carried out an analysis (attached, left) of the PCN DES draft service specifications, which were released at the end of last month, looking at aspects such as funding and the additional staff required.

It concluded that practices will face a deficit exceeding £100,000 per year, despite having access to the 22,000 extra practice staff partly funded by NHS England.

The document said: ‘These specifications carry an extremely high workload that would be impossible to deliver based on available workforce which exists within the health system.

‘These specifications offer no benefit to practices and are completely unrealistic.’

‘Cannot endorse specifications’

The LMC’s chief executives acknowledged GP practices would lose out on access to network funding by withdrawing from the DES but insisted the deficit to practices posed by the specifications would be ‘far greater’.

They said: ‘The LMC cannot in any way endorse these specifications, nor do we have any confidence that national negotiations will result in NHS England agreeing to sufficient positive changes.

‘We do not recommend practices renew the PCN DES in 2020.’

A separate statement released this week by Nottinghamshire LMC also suggests that practices question their involvement with PCNs.

It said: ‘When looking through the individual specifications, there are concerns about the capacity to do the extra work and it appears that much is dependent on additional staff freeing up capacity to take up the extra services and working across providers.

‘We need the draft service specifications to change dramatically to give PCNs to oxygen to breathe and thrive.’

It continued: ‘Otherwise the benefits of being members of PCNs will quickly be lost on member practices some of whom feel that the jury is very much out on whether this is the right way for general practice to go anyway.’

The statement added: ‘GPs will naturally start asking themselves whether they should sign up to the PCN DES in 2020/21 if it means that their national contract is going to continue to be affected as NHS England effectively overrides what it doesn’t like in the GP contract.’

NHS England listening to GPs’ concerns

NHS England said the final version of the specifications will be published in early 2020 as part of the GP contract for 2020/21.

It has previously said it is listening to GPs’ concerns and stressed it is collecting feedback on its proposals until 15 January.

The BMA has reassured GPs that any concerns about new network DES proposals are being heard ‘loud and clear’ and these will form the ‘basis’ of its contract negotiations with NHS England.

This article was originally published by our sister publication Pulse

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