The NHSE&I has concluded their engagement with general practitioners and health care staff in relation to the draft outline Network Contract Directed Enhanced Service (DES) specifications. Detailed below is a summary of the response published by the NHSE&I on Thursday 30 January 2020.

The NHSE&I published the drafts of the proposed service requirements prior to the contract negotiations in preparation for April 2020. Feedback showed support for the aims of the services themselves but voiced significant concerns about capacity and capability of PCNs to deliver the proposed requirements and the workforce challenges faced by primary care.

The concerns included:

  • The level of GP resources required to implement service requirements particularly enhanced health in care homes (EHCH)
  • The pace and scale of the transformation as all five services are being introduced in 2020/21
  • Recruitment challenges and the exacerbation of the clinical director work load
  • The suggestion that integrated urgent care/out of hours support for care homes may come under the authority of PCNs in the future
  • The high number of the metrics in the specifications that might be performance managed in monitoring delivery
  • Whether more qualitative measures and outcome metrics should be introduced
  • Geographical distribution of resources through the DES
  • How PCNs will be supported by CCGs and ICSs to deliver services
  • How system partners are expected to deliver the service in partnership with PCNs
  • How funding can be accessed and what support is available for issues such as boundary issues, data sharing, the make-up of multidisciplinary teams and availability of estates to house new members of staff
  • Issues regarding PCNs subcontracting services and digital solutions
  • Details of performance requirements for the metrics
  • The operation of the investment and impact fund

Detailed responses were also received on structured medication reviews (SMRs), enhanced health in care homes, anticipatory care, personalised care and early cancer diagnosis.

Read the full response published by the NHSE&I.