PCN clinical directors have shared their concerns over losing ‘good local support’ from both ICBs and NHS England, following the news of cuts to the healthcare system.
Last week, the Department of Health and Social Care (DHSC) announced that NHS England would be abolished, with its functions brought back into the DHSC to ‘end duplication’ across the two organisations.
It was also revealed that ICBs would be tasked with cutting their workforce by around 50%, which equates to 12,500 staff members across the system.
Speaking to the House of Commons Public Accounts Committee (PAC) last week, chief financial officer of NHS England Julian Kelly said the cuts would be for administrative roles not those providing frontline services.
However, the moves have prompted fears that it could have a detrimental effect on primary care.
Dr Geetha Chandrasekaran clinical director, North Halifax PCN, West Yorkshire, said that the shake up ‘may well push the integrated neighbourhood teams agenda’, but that their PCN has ‘good local ICB support’ and she is concerned this will be lost, as well as the ability to push local needs.
Dr Laura Mount, clinical director of Central and West Warrington PCN, Cheshire, also said: ‘I feel for my colleagues in the ICB and NHSE. Most of them work incredibly hard to ensure that patients receive good quality, safe services.
‘My fear is that we will now see an exodus of the best of the NHS England as staff worry about job certainty and so find other roles.’
She added there was a concern that workload would be passed onto PCNs and general practice.
‘I hope that this process is managed well and considerately considering the impact upon staff and patients,’ Dr Mount said.
Clinical director at Enfield Unity PCN, Dr Sarit Ghosh, said the re-organisation will leave a gap that ‘will have to be filled by PCNs and at scale providers’.
He added: ‘A broader more ideological concern I have is the loss of separation of the healthcare arm of government (NHS England) and the policy and political arm (DHSC). I think we will see politics increasingly define the future of the NHS and this may lead to short-termism and great disruption when new Governments come into power.’
Dr Sajid Nazir, clinical director at Viaduct PCN, West Yorkshire, said he had mixed views, and that on the one hand increasing efficiency and accountability and reducing waste was ‘welcome news’.
But on the other, he said he believes it could have a ‘detrimental impact on primary care’.
‘Examples of this would be administrative workload shift or delayed payments. I am also concerned that ICBs may cut down the clinicians employed by them, which would reduce our leadership and clinical representation,’ he said.
‘Finally, there are many experienced and skilful staff who may lose their jobs and this is a very difficult time for them.’
Though Dr Jeremy Carter, clinical director at Herne Bay PCN, said it was ‘hard to say’ what would happen now amid ‘uncertainty’.
He explained: ‘We have staff working under an uncertain environment which is never healthy, and I would imagine at least during any transition a negative impact on service delivery/improvement, just because time will be taken up in the process of organisational change.’
However, Dr Carter added that a lot of this was speculation and based on ‘what ifs’, and that PCNs ‘will stand ready to continue to strive to deliver the best care for our patients in whatever framework comes from this’.
A version of this was first published by our sister publication Pulse PCN
