NHS England and Improvement has published draft service specifications for primary care networks (PCNs). Views on the specifications are being sought in a consultation exercise that runs until January 15.

The document, which appeared just before Christmas, acknowledges the risk of “overburdening” PCNs at the early stages of development and says that the new requirements will be phased in “in a way that is commensurate with the capacity available”.

Through a combination of the additional workforce capacity within primary care, and the redesign of community services provision to link with and support PCNs, it is expected the Network Contract DES will aim to reduce workload pressures on GPs and support improved primary care services to patients.

Negotiations about the detail of the service specs are underway with the British Medical Association, with a final version due in early 2020. PCNs will be required to implement only two of the first five specs in full in 2020-21: structured medication reviews and enhanced care in care homes.

For the next three – anticipatory care, personalised care and early cancer diagnosis – the document sets out a “headline trajectory for the requirements over the next four years”.

Significant additional capacity

Providing that PCNs move forward swiftly to engage new staff and use their additional roles reimbursement entitlement, there will be significant additional capacity within primary care in 2020-21 to deliver the specifications, says the document.

It explains: “Recruitment decisions by PCNs will depend on their priorities but an average PCN could – indicatively – engage around 3 WTE clinical pharmacists, 1.5 WTE social prescribing link workers, 0.5 WTE physiotherapists and 0.5 WTE physician associates from April 2020. This would provide more than sufficient capacity to deliver the requirements across all five services with significant capacity remaining for these additional roles to provide wider support to GP workforce pressures.”

The GP contract framework, launched in January 2019, commits £978m of additional funding through the core practice contract and £1.799bn through a new Network Contract Direct Enhanced Service (DES) by 2023-24, as part of a wider commitment that, on current plans, funding for primary medical and community services will increase faster than the rest of the rising NHS budget over the next five years.

By 2023-24 spending on these services will rise by over £4.5bn in real terms – £7.1bn in additional cash investment each year by the end of the period.