The new government, the end of the 2019 contract and the push for neighbourhoods means the future and role of PCNs is more up in the air than ever before.  Here are four important questions currently facing PCNs.

1. How will the 2025/26 GP contract affect PCNs?

PCNs are not hugely popular with many rank and file GPs, understandably so given we have seen huge amounts of contract funding redirected away from practices and into PCNs.  The push from the GPC is for PCN monies to be shifted into the core contract.

However, it does not seem likely that there will be a whole new general practice contract for next year.  Back in 2019 the introduction of PCNs followed extremely rapidly on from the publication of the NHS Long Term Plan which came out in January of that year.  As the 10 year plan is not due out until “Spring” it is hard to envisage any large scale contractual change in 2025/26 following on from it, which means a modified version of what we currently have is most likely.

This in turn means PCNs continuing, although it would not be a surprise for the contract to at least contain some pointers as to what is on the way.

2. How will the forthcoming 10 Year Plan affect PCNs?

A much bigger (albeit medium term) impact on PCNs is likely to come as a result of the 10 year plan.  We are fully expecting neighbourhoods to feature heavily (given the government’s consistent determination to introduce a neighbourhood health service), and it does seem inevitable that the future of PCNs will be linked in some way to neighbourhoods.

A key question will be the nature of the relationship between PCNs and neighbourhoods, along with the extent to which neighbourhoods might be established as NHS entities and what powers/responsibilities/funding they will be given.

Will PCNs need to become neighbourhood-sized?  What will the role of the ARRS workforce be within neighbourhoods, and will general practice maintain the level of control they have over PCNs they have now?  Whatever the answers, it is hard to see PCNs continuing exactly as they currently are once the new plan is out.

3. Will all PCNs need to form Primary Care Collaboratives?

The NHS Confederation has written quite a lot about primary care collaboratives.  Rather than a PCN or GP federation they mean by this primary care providers coming together to operate at a system level, often as primary care boards.

At present, some PCNs are part of primary care collaboratives (where they exist) but many are not, largely because no such collaborative is in operation in their area.  As ICBs continue to mature, however, the importance of a voice that can articulate how general practice can contribute to and even lead the integration agenda is only increasing.

A key question for PCNs, then, is if they do not yet have a primary care collaborative in place do they need to be working to establish one?  Or if one exists is it effective, and if not what needs to change?

4. What can PCNs do now to prepare for what comes next?

Faced with so much uncertainty, making any form of preparation is difficult.  But that is not to say nothing can be done.  It is highly likely that the next phase of PCNs will be much more externally focussed.  As such it makes sense for PCNs to both ensure they have strong internal foundations in place (HR, finances, governance etc), and to be developing effective relationships with the other local providers and teams in their area.

If you are struggling with the uncertainty of how to prepare for what comes next for PCNs then the good news is that help is at hand.  I have teamed up once again with PCN Expert Tara Humphrey, and Dr Hussain Gandhi and Dr Andy Foster from the e-GP learning podblast, and we for the third year in a row are holding a PCN conference.

The purpose of this conference it explicitly to provide insights for those working in or with PCNs on what the future holds for PCNs and practical steps on how best to prepare for it.  It is taking place in Nottingham on the 23^rd April – for more information on how to book you place click here.