We enter 2024 without a clear steer as to what is coming next for general practice.  We know the existing 5 year contract, the one that created and developed PCNs, expires at the end of March, but what we still don’t know is what will be replacing it.  Faced with such uncertainty, how do practices and PCNs prepare?

A key part of getting ready is being able to respond quickly to any new changes that are announced.  NHS England is well known for delaying the production of guidance and then expecting general practice to respond within very short timescales to what are often major changes with far-reaching consequences, e.g. signing up to PCNs or establishing a Clinical Commissioning Group.

There are, however, a couple of things that can assist with this type of rapid decision making.  One is to read the detail of what is being proposed.  I am always surprised whenever I talk to groups of GPs how few actually read the documents in question.  While the documents are generally (deliberately?) inaccessible, relying solely on the interpretation of others can lead to skewed views about what is actually being put forward.

When digesting the new proposals the main questions to consider are what is the detail of what is being proposed, what will the impact of such changes be (on the practice, on the PCN), along with what the big picture implications of the changes are.  We might not have liked the details of the PCN proposals but the big picture implication was always that this was going to be the only way the practice could access new resources in the foreseeable future.

As a sidenote, a good preparation for what might be coming would be to read the Fuller Stocktake report.  This has become the de facto general practice strategy document (despite it being a report on integrating general practice with the rest of the system, but let’s not get into that again), and the author has since been appointed the National Primary Care Medical Director at NHS England.  Last year’s contractual changes around access were signposted in the Fuller Report, and it would be a surprise if whatever new emerges has not at least been mentioned in this document.

For an even more thorough preparation read the NHS Confederation’s document entitled, “Supporting General Practice At Scale: Fit for 2024/25 and beyond”.  In it they have, “identified a set of tangible recommendations for the upcoming GP and primary care network (PCN) contracts for 2024/25”, and whilst we would not be expecting the NHS Confederation to be determining the future of general practice, I explain why the document is important here.

The second action that can help prepare for what is coming is to find out from those people already doing the type of thing that is being suggested what the reality is actually like.  Unless the new proposals are one man’s crackpot scheme (CCGs may fall into that category) then there is normally always a predecessor, like the primary care homes that preceded PCNs.  Learning from the real life experiences of others can provide valuable clues to identifying the best way forward for ourselves.

Of course this requires the details to be published, but again there are emerging examples of some of the things included in the Fuller Report (like Integrated Neighbourhood Teams) developing across the country.

The good news is that help with all of this is at hand.  For the last two years I have been working alongside eGP Learning GPs Dr Hussain Gandhi and Dr Andy Foster and PCN expert Tara Humphrey in delivering PCN Plus, a training and support programme for PCN leaders.  Together, we are putting on a conference on Wednesday April 17^th in Nottingham which is free for all practice and PCN staff to attend, when we will be both giving our take on what is coming (we think that even NHS England will have published the plan for 2024/2025 by April!), and be showcasing examples from those already further down the track.

If you want to make sure that you are ready for next year when the time comes then you can sign up for our free conference here (places are available on a first come first served basis) – I look forward to seeing you there!