In the NHS Five Year Forward View. 2014, Simon Stevens uniquely for an NHS senior leader, emphasised – ‘The foundation of NHS care will remain list-based primary care’.
And now we have Primary Care Networks (PCNs) the base unit in responsibility for England’s health care, populations circa 30,000 to 50,000 people served by groups of GP practices working with NHS community services, social care and other providers to deliver more co-ordinated and proactive services.
How did this happen?
It began with the ‘bottom up’ voluntary Primary Care Home initiative which captured the imagination and enthusiasm of clinicians, managers, senior officials alike and in particular the supportive NHS England Chief Executive. The Primary Care Home concept was originated by the author in 2009, its overarching aim being ‘a population based (GP registered list) community provider possessing its own budget and ultimately providing an alternative to current NHS hospital centricity’. And importantly a responsibility for broader health and wellbeing where a bio-clinical focus and addressing the social determinants of health can be the responsibility of one provider organisation.
The Primary Care Home idea was brilliantly advanced by the National Association of Primary Care (NAPC) and the 240 innovative and often transformational nationwide volunteer sites, so much so that to quote a senior NHS England leader – “The Primary Care Home is the precursor to current national policy of Primary Care Networks (PCN).’’The primary care paramountcy that is essential to NHS sustainability is equally essential for local patients and public, it is where most NHS care and support takes place This is not a claim for a primary care power grab but to be influential partners in a more dispersed leadership.
Can Primary Care Networks succeed?
The former 240 Primary Care Home sites make up nearly 20% of all PCNs offering a wealth of knowledge, experience and leadership to support progress. We now have approximately 1250 PCNs. In the year ahead they are set to be the building blocks of integrated care systems, and the immediate challenge is for them to be a major part of the current Covid-19 vaccination effort.
We can’t afford for them to fail.
By Professor David Colin-Thomé, OBE, chair of PCC and formerly a GP for 36 years, the National Clinical Director of Primary, Dept of Health England 2001- 10 and visiting Professor Manchester and Durham Universities.