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How to Make Primary Care Networks (PCN’s) Work for Your Practice

Since the NHS was created in 1948, the population has grown, people are living longer, and many are living with long term conditions says NHS England. Part of the NHS response is the creation of Primary Care Networks (PCN’s).

PCNs will be a major influence on the way GPs work, and the way care is provided, in 2019. In this post we examine what PCN’s mean for GP practices and review the actions they need to take in the short term.

What are Primary Care Networks (PCN’s)?

  • They are based on GP registered lists and serve communities of 30,000 to 50,000 people
  • Small enough to provide the personal care valued by patients
  • Large enough to benefit from economies of scale
  • Designed to take pressure off GPs
  • Ambition to cover the whole country by the end of 2019

Source: https://www.england.nhs.uk/gp/gpfv/redesign/primary-care-networks/

The rationale for PCNs
Dr Nikita Kanani, MBE, lead for GPs at NHS England, is one of the driving forces behind the new GP Contract including the establishment of PCN’s.  While acknowledging that the individual GP practice is still ‘priceless’, Dr Kanani says it’s the change in philosophy and the NHS relationship with local partners that will bring about the real change – ensuring the care system can cope with demands by switching “from reactively providing appointments to proactively caring for the people and communities they serve.”

How will it be funded?
£1.8bn of funding will be available over the next five years, and allows for the biggest reform most GPs will have seen in practice. Funding includes 20,000 new staff, support for clinical leadership, development at a local level and investment in innovation. Funding is based on list size at January 2019 and is updated and paid each year. You can find out more by listening to this interview with Dr Nikita Kanani

A move from reactive to proactive care
The change in infrastructure has the potential to reduce workload for GPs and enable them to better serve their community. Under the PCN structure, practices will be able to share team members and premises and have greater control over services in their area.

However, we know from conversations with GPs that there are some short-term concerns about making PCN’s work. In busy practices workloads are already heavy and there is little resource to dedicate to meetings and planning.

New skills may be required too. The PCN’s that are already flourishing have great leadership. Working within a new structure, employees will need to have leadership, team building and organisational development skills that may not previously have been part of their roles.

A lack of people, time and money is compounded by worries about a loss of control, financial pressures and questions around communication, governance, roles and responsibilities. However, there is pressure from NHS England for GPs to be proactive about joining a PCN.

So where should you start?

Where and when to start planning
Advice is for GP practices to start talks now with neighbouring practices about forming a PCN. Practices will be expected to submit a plan to their local CCG in the coming months, setting out their list size, geographic area, nominated provider to receive payments and naming a Clinical Director to represent the member practices.

How do we make it work?
How do we become part of PCN? Do we choose or will we be told we’re part of a PCN? Can we request funding ourselves? Will we need new skills and capabilities in our practice to manage PCN involvement?

These are the types of discussions that the Miad Healthcare team had when we ran our first workshop this month. We answered common questions and helped practices and confederations of practices plan their future as part of a PCN.

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  • Ruth Frost, Provider Development Lead/Advisor, Health London Partnerships, NHS England. - Miad were a pleasure to work with, engaging, perceptive and flexible to the changing needs as the programme rolled out. They engaged well with the wide range of General Practice
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