Our response to the PCN service specification focused on highlighting the current concerns that service users tells us about accessing GP services. We also shared the findings from our study on ‘what matters most: support people want from general practices in Birmingham’ to highlight what people value from GP services. We therefore asked NHS England to consider these experiences in the implementation of the specification noting the additional pressures this placed on GPs.
For instance, we questioned the efficacy of requesting GPs to carry out medical reviews during the ten minute appointment times allocated to each patient. Other issues we believed the PCN failed to take into account is the ability of practices to adhere to the timelines set by NHS England for meeting specifications for those PCNs with a higher population of patients who are more likely to need a structured medical reviews. Also, it was not clear whether the diversity of the populations for PCNS, especially for places like Birmingham, had been considered, especially the impact of this on the progress of PCNs and variation that might lead to greater costs for some PCNs.
Our key concern raised in the response was the absence of the role of patients, service users and members of the public in the service specification. None of the proposed metrics designed to monitor the success of the service did not include the use of patient feedback or experiences. We therefore asked NHS England that the use of patients, service user and carer’s insight and experience to identify barriers to improved health outcomes should be woven into this specification. This, we argued, would help the NHS to understand the experiences of people of PCNs and use this insight to inform service improvement or other decision-making processes.