Large GP network at risk of collapsing over ‘private conversation’ row

Seven GP practices have withdrawn from Skegness and Coast’s PCN contract after they were “unable to envisage delivery” of NHS England’s new enhanced health in care homes specification. However, three have subsequently attempted to create a new network.

The specification, which is part of the direct enhanced service contract, included a requirement that PCNs provide weekly virtual ward rounds of care home residents. It was introduced as a major part of the PCN contract for 2020-21, agreed by NHSE and the BMA, despite dissatisfaction from some doctors during negotiations.

Stephen Savory, a GP working in one of the practices that withdrew from the contract on 31 May, says the seven practices had refused to agree to the specification, but Lincolnshire Clinical Commissioning Group entered a “private conversation” with three practices about delivering the service through a new PCN.

In a letter to the CCG, shared with the media, he said these conversations were “hasty, ill-conceived and have created a problem far greater than that the parties sought to address”.

He said they had also resulted in the resignation of a “respected” clinical director of the original PCN, Dr Ben Moore.

Dr Savory said the four remaining practices served 26 care homes. The letter added: “We invite the CCG to advise how we might properly deliver the EHCH specification to all residents with the inadequate resources available to us.” He claimed that two other PCNs in the area, Boston and East Lindsey PCNs, “have indicated they do not have the capacity to deliver the PCN DES” either.

He said there was now no network to serve the patients in the Skegness & Coast division of the CCG, or to facilitate the primary care response the covid-19 pandemic.

A spokesman for Lincolnshire CCG said: “Following the decision of a number of GP practices in the Skegness and Coast PCN to opt out of the DES for 2020/21, Lincolnshire CCG is responsible for ensuring the total population is covered by the contract network DES 2020/21, and is continuing discussion with all practices on how this will be achieved in line with contract specifications by 30 June 2020.”