There is a lot of talk at present about pay rises for practice staff and ARRS staff but what about PCN Clinical Directors?  Should PCNs and practices also be considering a pay rise for this important group of staff?

Many PCN Clinical Directors have been in the role for many years, some since the inception of PCNs back in 2019.  While a minority of more progressive PCNs have actively considered the notion of pay progression for their Clinical Director, the majority have not.  In part, this is because prior to this year the funding allocated to the Clinical Director role was always specified in the PCN DES as 72.9p per patient, and so this was the amount paid.  In part, it is because the only people who pay real attention to the incomings and outgoings of the PCN are the Clinical Directors, and it is very difficult for them to suggest a pay rise for themselves.

But while the reimbursement has not changed, the role of the PCN Clinical Director has grown considerably over the last five years.  Many now have overall responsibility for an army of ARRS staff as well as a range of joint service provision such as extended access and vaccination services.  From operating initially as a one-man band many CDs now lead a significant PCN team and have a range of external responsibilities on behalf of the PCN.

It would make sense, then, if the reimbursement for the role kept pace with the growth in responsibility.  Not only that, but retention of PCN CDs is an important issue.  High quality PCN Clinical Directors are in relatively short supply.  Most PCNs do not have a queue of suitably skilled individuals who could just step into the role.   Just because your PCN CD has not mentioned a pay rise does not mean that they are happy without one.  Failure to provide a pay rise may ultimately lead to PCN CDs walking away from the role, primarily because of the lack of recognition that it signals for the work they are doing.

In theory the shift away from a separate Clinical Director payment (£0.729 per patient), PCN leadership and management payment (£0.684 per patient), and core PCN funding payment (£1.50 per patient) into a newly combined core PCN funding payment of £2.916 per patient this year should have provided much more flexibility for PCNs to re-consider the payment for their CD.

However, the reality is that the core funding element of PCN monies has always come under much more scrutiny and control than any other element, as practices are mindful that any amount unspent in this pot can be returned to practices.  As such the purse strings of the new combined pot have in many places become much tighter now than they were previously on the leadership and management payment, making practice agreement to a proposed rise much harder to achieve.

So PCN CDs who are desperate to either recruit or retain their management support will often prioritise uplifts for these staff over themselves (and will often struggle to get those through), and the issue of whether the CD should have a pay rise never even gets consideration.  I am yet to hear of a PCN that has a separate renumeration committee (although I am sure you are out there, but do get in touch if you are and it is working!).

My advice to PCNs, especially those with an effective CD in place that they want to keep in the job just as long as they are willing to do it, is at this time of salary reviews and changes to make sure that the PCN Clinical Director does not get overlooked, and to consider an uplift to their remuneration as a tangible recognition of how the role has developed and grown over the past few years.