• GPs reject contract agreed by union and NHSE in February
  • GPs vote for motion calling PCN scheme “Trojan horse to transfer work from secondary care to primary care”
  • Although non-binding, vote shows dissatisfaction with PCNs 

GPs have voted to reject the primary care network contract signed by the British Medical Association and the NHS, delivering a blow to the crux of the long-term plan.

Doctors at a special conference of local medical committees voted for a motion saying the PCN scheme is a “Trojan horse to transfer work from secondary care to primary care”.

They voted by three to two that the profession should reject the contract “as currently written” and said the PCN strategy is “an existential threat to the independent contractor model”.

The LMC conference called on the BMA’s GP committee for England to “urgently negotiate investment directly into the core contract as the only way to resolve the crisis in general practice is by trusting GP partners with realistic investment”.

The contents of the “directed enhanced services” contract had been negotiated and signed by the BMA’s GP committee and NHS England.

They agreed to a new DES in February after the GP profession near-unanimously rejected a previous draft specification, published by the NHS in late December for consultation.

The DES is in addition to the core GP contract and it is not obligatory for GPs to sign up. Today’s vote is not binding upon the GP committee, which is not now obliged to renegotiate terms with NHSE.

But it is a clear signal many GPs may choose not to sign up again to the latest DES, and casts doubt on the future of PCNs and, with them, the wider integration agenda set out in the long-term plan.

The DES called on practices to tell their clinical commissioning groups whether they intend to stay in the contract by the start of April to ensure there is no interruption to their PCN related payments, though the deadline to sign up is 31 May. If they choose to opt out, they must give a month’s notice by 31 May.

GPs are concerned by the workload they are having to meet with a dwindling workforce and many today expressed disappointment at how the PCN agreement failed in what they saw as its core function, of shoring up general practice in England.

In June 2019, NHSE said stabilising primary care was one of five things it hoped the new care model would deliver by 2023-24. It also said it expected PCNs to become a means of delivering services in the community, in conjunction with community health providers.