Maybe your practice has never worked well with other practices.  Maybe you have avoided it, as far as has been possible.  The new GP contract, with so much money going through the new primary care networks, means this strategy of avoidance is not going to be an option any longer.  What do you do now?

There is a perception that primary care networks are not really anything new, that they have been happening anyway.  I don’t think this is true.  According to the NAPC website, 16% of the population is covered by the forerunner of primary care networks, primary care homes.  NHS England state that according to CCG returns 80% of practices report being in some form of network.  A generous estimate might put the real figure of the percentage of practices that have actively sought to work with their neighbours in some sort of meaningful way in the middle of these two, which would be about 50%.

That means half of practices are in the situation of having to work with other practices for the first time.  It means while half of the practices are building on some sort of foundation, making progress, and generally intimidating those who don’t know what to do, half are simply trying to get their heads around what the new world of networks means.

I have spoken to a number of people recently, asking what advice they would give to GPs and practices in exactly this situation.  I asked an accountant, a lawyer and the Head of Primary Care at NHS England.  Interestingly, all three came up with exactly the same answer.  Go for a drink or for a meal with your local practices.  Get to know them.  Build the relationships.

The questions GPs and practices ask when reviewing new guidance or documents such as the new GP contract are often technical.  What will the accounting relationship be between the new network and my practice?  Will we incur VAT charges?  Who will employ the staff, and where will the risk sit?  These are all valid questions, but, even according to an accountant and a lawyer, they are not the place to start.

A few years ago a colleague of mine took up a new post as an Executive Director in a large teaching hospital.  On her first day she met with the CEO.  He said to her that he didn’t want her to do anything for the first month, just to build relationships.  She was stunned.  She wanted to prove her worth, and was worried that she would be seen as someone without focus on delivery.  But years later she reflected it was the best advice she could have been given.  She said too many people start to try to do things without having relationships in place.  Delivery then happens at the expense of those relationships, not through them.  But because she was given the time to develop strong relationships she was able to deliver far more than if she had just jumped straight in.

The same applies to GPs and practices looking to set up new networks.  The whole rationale of the 30-50,000 population size is about relationships.  It means the people operating within the network can all get to know each other and have a personal relationship, and not be of a size that inevitably creates distant, faceless bureaucracies.  So if the basis of the new primary care network is relationships, the best starting point is to build these relationships.  While it might feel indulgent when the timescales are short, time invested now will repay in buckets in the months and years to come.