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CCGs are trying to ‘manipulate’ formation of networks, BMA told

by Léa Legraien
12 March 2019

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CCGs in some areas of England have been trying to ‘manipulate’ new primary care networks to ensure they align with their own plans, according to the BMA.
GPs told our sister publication Pulse, where this story was first published, that a number of CCGs have been trying to influence how networks are set-up, including telling practices which GP should become their clinical director.
When announcing the new five-year GP contract, NHS England and the BMA said formation of the new primary care networks should be GP-led, with CCGs becoming involved to make adjustments to membership and boundaries where necessary, for example where a practice falls between two networks.
But speaking at an event last week – outlining the new GP contract – BMA GP Commitee executive team member Dr Farah Jameel said GPs are reporting cases where CCGs are telling them who should be their network director and how they should form geographically.
Dr Jameel said: ‘We have heard from around the country that there have been different approaches suggested, which include CCGs telling primary care networks who their clinical directors should be, and CCGs telling primary care networks what their geography and boundaries should be in order to align with local community teams.’
‘Our advice and guidance is that it is imperative that the formation and development of primary care networks should be led by GPs and practices,’ she added.
Under the new five-year contract, all primary care networks must submit registration information to their CCG by 15 May 2019.
CCGs are then required to confirm registration requirements and approve variation to GMS, PMS and APMS contracts for all networks by 31 May 2019.
GPs in Lancashire and Lincolnshire told Pulse practices in their region have experienced issues with local CCGs.
Lancashire and Cumbria LMCs chief executive Peter Higgins said: ‘We have some anecdotal evidence of one CCG that is trying to reinvent the wheel and manipulate practices in a particular way to create one large primary care network fitting their footprint.’
‘Generally we are seeing an acknowledgement that primary care networks will develop from the bottom upwards but there are inevitably people out there that want to protect their own interests,’ he added.
Meanwhile, GPs in Lincolnshire said the CCG told practices that networks would have to align with existing neighbourhoods teams – a grouping of professionals including GPs – to fit with the local vision.
Lincolnshire LMC medical director Dr Kieran Sharrock said: ‘Initially our CCG/STP lead stated that primary care networks would need to align with already created community trust neighbourhoods.
‘Thankfully when we challenged this, the NHS trust agreed to be flexible to allow for the primary care networks configurations.’
He added: ‘The CCG/STP lead has acknowledged this position, although I am still anxious that the primary care networks which are developing will receive pressure to align to the STP vision.’
Under the five-year contract, primary care networks will be based on geography, covering 30,000 to 50,000 patients, and led by a local GP in a clinical director role.
NHS England said every network will allow general practice to ‘take a leading role’ but pointed out ‘marginal adjusment to primary care network membership and boundaries’ might be needed in some CCG.
The GP contract said as of October 2018, 88% of practices in England had chosen to join or lead a Primary Care Network, according to CCG data.
But last month, Pulse reported that many existing federations of GP practices will not be counted as networks, because in ‘most areas’ federations are ‘too big to be regarded as one primary care network’.
This story was first published on our sister publication Pulse.