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Primary Care Networks: how to succeed in reducing inequalities

According to a recent report from the RCGP, developing the community health function of general practice is one of three features of the COVID-19 response that has the potential to transform general practice radically and permanently. And primary care networks (PCNs) are NHS England and NHS Improvement’s chosen vehicle to drive engagement between primary care and communities, supported by the network directed enhanced services (DES) contract.

Merron Simpson

There is a problem, however, with how ‘communities’ are understood and with the tools that have been provided to do this job. The new roles available through the additional roles reimbursement scheme (ARRS) do help, but only a little. Here’s how one local authority communities programme lead described the issue: “the DES contract has put the operational level in … the social prescribing link worker is that connector. But the strategic role … there’s a gap between the clinical director and the strategic level”.

In every place, beyond the boundaries of the NHS, there are many groups, organisations and networks that are fully bought into tackling health inequalities; addressing the wider determinants and supporting the social processes involved in creating health which mainly happen in people’s homes, neighbourhoods, workplaces and wider networks. They are enabling individuals and communities of all ages to have better physical and mental health and a good life and the networks between them have been strengthened, not weakened, through COVID-19.

Many within primary care are becoming more aware of the potential of connecting with this large pool of possibility. One PCN clinical director expressed this saying, “you need to be in the forum, to be in the conversations for all the other possibilities to emerge”.

The Health Creation Alliance has set about unpacking this ‘community layer’ for the NHS and helping primary care to connect constructively with it. Our recent report ‘How can Primary Care Networks succeed in reducing health inequalities?’, jointly published with the RCGP, builds on the premise that ‘lasting reductions in health inequalities will only be possible through working in genuine partnership with communities… by seeing them as part of the system and a significant part of the route to lasting solutions’.

‘How can Primary Care Networks succeed in reducing health inequalities?’ can be found here.

A quick start guide for PCNs

  1. Don’t wait until the Tackling Neighbourhood Inequalities DES kicks-in, start now
  2. Involve your local communities and local partners in shaping your PCN.
  3. Make sure your PCN governance arrangements include people from diverse communities.
  4. Share the process of developing your actions for tackling health inequalities with local partners.
  5. Support member practices to work with communities as equal partners in pursuit of improved population health.