Make your primary care network work for you

20 March 2019

Tracy Green

By Tracy Green

Spring is a busy time for practices.

This year, as well as the annual delights of year-end reporting, QOF, DSP and the day job, practice managers have been told to get on with forming primary care networks (PCNs).

“Told” because “working at scale” is no longer just a helpful suggestion but a matter of policy. Participation of individual practices is officially optional, but as there are going to be financial incentives for working in networks – and diminishing prospects for those who chose to rely on the core contract – the element of choice is more limited than it may appear.

Just because it’s not compulsory doesn’t mean you shouldn’t do it.

New policy often appears with at best opaque funding pledges. This one comes with clear and sizeable incentives for GP practices for getting involved now and specific commitments to increase funding in future. The five-year contract framework published by the BMA and NHS England makes it clear that with PCNs the government is making a long term investment in general practice.

So the question is not about whether or not to we take part in PCNs but:

  • How can we make the most of new opportunities for funding?
  • How can we ensure that working in a network makes life easier not harder?
  • How can we form a PCN quickly enough to meet the tight national deadlines but still allow enough time to form good relationships and make the right plan for us?
  • How do we realise the benefits of working at scale without the drawbacks – loss of identity and control?
  • How do we take charge of the process to ensure that we get the PCN we want rather than the one someone else thinks we should have?

Plenty of organisations will be offering to answer these questions for you but the truth is that there is no guaranteed model or fool proof formula for making it work. Successful PCNs will be those that are based on mutual trust, shared interests and objectives, well defined responsibilities, realistic goals, effective governance and clear leadership.

These will all need to be locally developed, nurtured and made by you and your colleagues. They can’t be drafted in, grafted on or imposed contractually.

Between now and July, by when PCNs are expected to have formed across the country, expect to see a torrent of information, advice and instruction telling you what to do. There will probably be less clear advice on how to do it. Here are a few things to think about if you’re not doing them already:

  • Use your local practice managers’ network to compare notes and talk tactics with colleagues
  • Follow the progress of practices that were already working in effective primary care networks long before PCN became an official term. Contact them to find out how they did it or ask them to come and speak at your next meeting
  • Keep up to speed with policy – what’s in the press and on the grapevine as well as official announcements
  • Follow the money – practices need to know how they are going to get paid. Understand the contract and payment mechanisms for services provided by the network
  • Think about employment issues – a bigger, more diverse workforce could bring big benefits but also some challenges. Fortunately there’s already good evidence about what works.

Few practices will welcome having more to think about at their busiest time of year, but they can’t afford to ignore PCNs. They shouldn’t panic either.

Creating the sort of organisations envisaged by the policy will take years in some cases, particularly truly integrated working with social care and community services.   

But the scale of the task, not to mention the incentives on offer, means you really need to start now.

If you want to know how we can help you get your network started and on the right track, get in touch.

Tracy.green@pcc.nhs.uk

Tracy Green is an award-winning former practice manager who now supports primary care development as a PCC adviser

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