Network contract directed enhanced service: draft outline service specifications

There is a capacity crisis in general practice, with insufficient available workforce to meet current levels of demand. We welcomed the five-year GP contract framework published in 2019 but raised concerns about the capacity to deliver its aims: to stabilise general practice; to act as a key link between general practice and the rest of the health and care system; and to deliver key elements of the NHS long-term plan, through a set of new service specifications.

The urgent action needed to stabilise general practice, by addressing workload and workforce issues, raises important questions around the timing, implementation and pace of these new service specifications even though the overall direction they set out is the right one.

The King’s Fund, along with other commentators, has cautioned against primary care networks being set up to fail by requiring them to take on too much too quickly. While the consultation document acknowledges this risk and suggests a staged implementation, we believe the tasks required for 2020/21 are undeliverable and will not allow primary care networks to focus on stabilising general practice, addressing the pressures that are manifesting in declining patient satisfaction with access to services and issues of retention in the GP workforce.

We welcome the opportunity to contribute to the network contract direct enhanced service (DES) draft service specifications. Our detailed response draws on our policy research, including our work on general practice, care homes, community services, social care and place-based care; and our work providing leadership and organisational development support to primary care networks.