Proposed NHS Primary Care Network specifications may be unworkable warns RSM

Commenting ahead of the 15 January closure of NHS England's (NHSE) consultation on the service specifications required of GP practices working within Primary Care Networks (PCNs), James Gransby, a partner at RSM who specialises in GP practice accounting said:

'Based on the submissions which have been publicly circulated so far, NHSE has certainly been lambasted by those at the front line who have to deliver the five specifications proposed in the consultation.

'PCNs have the power to relieve pressure from the endemic workforce issues that GPs face, but the proposed service specs will burden GPs with too many extra deliverables too soon with insufficient funding. This will add to the pressure rather than reduce it.

'When the extra time taken to deliver these service specifications is costed, it could add more than £100k in extra cost per average sized practice. This is after full entitlement to IIF money has been factored in. This makes ongoing engagement for many practices unaffordable without either a significant rewrite of the specs, or considerably more money being made available to the networks.

'Money in itself will not solve the workforce issue as there needs to be more new people on the ground - and not just roles transferred from existing practices into the PCNs. The reimbursement scale rates for a number of the roles are too low to attract the right talent. This means that more than just the 30 per cent salary cost shortfall would need to be met by the practice, or by an extra injection of funds from local CCGs.

'NHSE has an opportunity to show that it is genuinely listening to the feedback, as without a fundamental rewrite it looks very likely that many practices will turn their back on the proposals in an effort to survive. 

'The mood is not that the proposals aren’t admirable, or that they are incorrect. Rather it is too much to deliver based on the current state that general practice finds itself in after years of underfunding into primary care and the workforce crisis engulfing front line GP services.'

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