Senior GPs have reacted with alarm to the publication of proposed new targets for primary care networks, warning of a “worrying lack of insight” into pressures on practices.

NHS England published its latest draft proposals just before Christmas, seeking to row back on pressure to achieve its five targets. But its proposals would still mean two objectives have to be delivered in the coming year, relating to structured medicine reviews and enhancing health in care homes.

Now Nottinghamshire Local Medical Committee has spoken of being “deeply concerned” at the lack of insight into the current pressures on practices. It warns that practices could refuse to take part in primary care networks – which are being set up as a national system following the signing of the latest GP contract last spring.

The LMC calls for “dramatic” change to the proposals to ensure the success of the networks.

In its response it says: “We do not wish to come across as luddites, the negative voice in a new exciting world. We are supportive of any initiatives aimed at supporting patient care by reducing postcode lotteries, inequity of access and quality of care etc and can see clear benefits to working together practice to practice but also locally across disciplines.

“Our thoughts are more geared towards interrogating the suggested service specification and thinking about what it means for general practice practically, an already overburdened profession that is finding it difficult to stay afloat.”

NHS England has stated that networks should be moving forward “swiftly” to recruit thousands of clinical support staff, arguing that this will give sufficient capacity for the new objectives. But it has accepted that fast recruitment could be difficult.

However the Nottinghamshire LMC states: “The truth is that general practice needs the additional resources just to allow it to do the day job and perform to its core contract never mind the additional work that is being requested. We support the notion of working collaboratively where unnecessary duplication exists but it takes time for new care models to form and perform and this feels like a very early introduction of new pathways in a very immature landscape.”