What is on the horizon for general practice in 2022?  Here are 5 things to watch out for in the year ahead.

February: Contract Negotiations.  We are three years in to the 5 year deal agreed in 2019, so you would think that contract negotiations this year would be relatively straightforward.  However, once you throw in Covid, the government’s concern with GP access, a new GPC leadership team, and the vote in support of industrial action made by the profession at the end of last year, the negotiations this year could well be a spikier than normal affair.  Despite the profession’s reaction there has been no softening of the national stance on GP access, and so it will be very interesting indeed to see what comes out of this particular set of negotiations.

March: PCN Review Report.  In November last year a review of PCNs was announced, and how “they will be working with partners across newly formed integrated care systems”.  Potential concerns were highlighted at the time, namely that it implied a need for more national control over PCNs, that it could signal a shift of ownership of PCNs away from practices, and that it may very well further distance PCNs from the pressing issue of general practice sustainability.  This report is due in March, most likely coinciding with whatever comes out of the contract negotiations, and there is a good chance it will have big implications for general practice.

June: 3 years of PCNs.  It may only feel like yesterday but in June it will be three years since PCNs were first established.  PCNs now, with their large team of additional role staff and increasing set of delivery responsibilities, are significantly different from what they were back in 2019.  However, three years may also mark the end of the tenure of many of the initial PCN clinical directors.  While we have experienced some turnover of CDs already, this year could well see a much a greater turnover with many coming to the end of the term they initially agreed, and taking on the role may prove a tough challenge for those coming new into the role this year.  How this affects PCNs as a whole is something only time will tell, but unless more support is put in place it is unlikely to be positive.

July: Integrated Care Systems go live.  It feels like we have been living in the shadow of integrated care systems for some time now, but (according to the new planning guidance) they will finally go live in July this year.  This means CCGs will formally be abolished, and general practice will be left to fend for itself amongst the other providers as we all ‘work together’ to agree how care is organised and how resources are divided.  The extent to which general practice can influence and impact these new systems may well be very important in determining the level of local investment and support in the service going forward.

October: Shift of Extended Access to PCNs. Well, maybe.  This shift was supposed to happen in April last year, and then in April this year, and now in October this year, and the continual delays do raise the question as to whether this shift will ever really happen.  But if it does it may well spell the end of financial sustainability for the significant number of GP federations that rely on this funding, and this in turn could well create difficulties for both local practices and PCNs.  It is an issue that when the guidance (finally) comes out will need some working through to ensure we don’t end up with more problems than we have now.