Coming together under pressure: Network DES 2020
Justin Cumberlege, a partner in the healthcare law firm Hempsons, highlights some key points in the new Primary Care Network direct enhanced services contract
Published in Practice Management May 2020
Primary Care Networks (PCNs) will become more well defined and will play a bigger role in the delivery of primary care services with the implementation of the Primary Medical Services (Directed Enhanced Services) Directions 2020 on 31 March 2020.
The accompanying specification demonstrated that NHS England was not going to slow down on the evolution of PCNs.
For well established PCNs, the main issue is to confirm the care homes for which the PCN will be responsible (by 31 July) and to submit the workforce plan by 31 August, which means deciding which additional staff for the 10 roles specified you want to engage.
For those who were unable to form coherently in the past year it is not too late to get your house in order, ensuring that you have an agreement with which everyone is content, and adequately sets out how decisions are made, how the clinical director is appointed, and money received and paid out.
Schedule 7, which concerns engaging with other organisations, will become more important in the drive to integrated health and care services. It would be expected that successful PCNs will be working with other providers, with the PCN as the hub for the provision of health and care to the local population. These details need to be agreed by 30 September 2020.
The DES Contract spells out that every practice in the PCN is liable to perform the services, which means every partner of every practice is responsible for the service over the population covered.
‘The fact that the DES contract is part of the GMS or PMS contract means that any breach of the terms is a breach of those contracts, with the same remedies available to the commissioner’
Once you have signed up for the DES contracted services, you are committed until 31 March 2021 to provide them, unless you decide as a practice to leave the PCN. The commissioner is likely to try to persuade you to remain, as are your other PCN core practices, as they will have to fill the gap, unless you move to another PCN. You also need to be aware that you will be auto-enrolled into the Network Contract for 2022/23 unless you serve notice within a month of the specification being published. If you are struggling to provide the services, you may have to take advantage of that option, even though it means you will lose the right to provide any DES services.
The fact that the DES contract is part of the GMS or PMS contract means that any breach of the DES contract terms is a breach of those contracts, with the same remedies available to the commissioner, including termination. However, the commissioner is required to take appropriate action, and act reasonably, including the agreement of a collaborative action plan.
Only if you failed to implement the plan without good reason would the commissioner issue breach or remedial notices or consider withholding payments or even terminating the DES contract.
There is to be more funding agreed and published by 1 October 2020, so this would probably be a good time to look out for further financial assistance.