The new primary care networks are “at a crossroads” with controversy over targets and an inexperienced leadership, according to a new survey.

More than half of the clinical directors appointed by the networks are taking on their first leadership role, the NHS Confederation found.The networks are meant to be the building blocks of the future NHS, employing staff for practices and providing a range of out of hospital services.

The clinical directors said they lacked management support and were confused about the funding available to them. And they raised concerns about whether the controversial service specifications set by NHS England are properly funded. These include regular visits to care homes. Some 157 clinical directors responded to a survey.

One clinical director said: “It is very difficult to do the day job of running a practice with PCN work on top. We can’t possibly deliver that sort of workload.”

Another said: “I find myself doing PCN work squeezed into an already busy clinical day and in my spare time. I feel unsupported and stressed.”

Ruth Rankine, the Confederation’s development director for primary care networks, said: “The Government has set out ambitious plans for primary care which recognises its vital role in the system, but this vision is at risk of being nothing more than a pipedream because the fundamental building block for this transformation has not been given appropriate time and investment.

“It has been only six months since primary care networks have set up across England and despite the huge potential, there is overwhelming concern that they are far from prepared or resourced to deliver what is being expected of them. In particular, clinical directors have told us that they need more time, more support from their local systems, and greater clarity around funding for what is being asked of them.”

The Confederation’s senior clinical adviser Dr Graham Jackson said: “The future of primary care is at a crossroads with many clinical directors committed to the opportunity to strengthen general practice and provide new and enhanced services for their patients but they are faced with proposed national requirements for primary care networks that they feel are impossible to deliver in their current form.

“While there are many strong examples across the country of primary care networks flourishing, equally many clinical directors are struggling and are concerned about the sustainability of the model.”