In the update to this year’s GP contract the increase in funding for additional roles for PCNs from 70% to 100% was heralded in this way:

“We have heard that the £1.50/head support for PCNs – worth £72,000 annually for an average PCN – has been deployed to contribute to the 30% funding of additional roles.  Instead it can now be used as needed for development and transformation support.  It equates to a full-time band 8A, and increasing the contribution of Clinical Director time by almost 50%.  We encourage Clinical Directors to use the funding to ensure sufficient support as rapidly as possible”.

A band 8A manager, for those not fully conversant with NHS pay scales, attracts a not insignificant salary of between £45,753 and £51,668.

Some PCNs have taken the plunge and employed a manager.  Others are more reticent.  The relative ease with which the PCN requirements were able to be handled in 2019/20 meant many PCNs decided to return much of the (unused) £1.50 to practices at the end of the year, and in doing so set a precedent that some PCN CDs are now uncomfortable breaking.

Part of the problem of course is that a salary of c£50K for a PCN manager is significantly higher than the salary of the average practice manager.  On the one hand, PCN CDs don’t want to be accused of stealing practice managers from local practices, and on the other it is very hard for a manager with no local knowledge to come in and work effectively across practices.  Especially when the local PMs know exactly how much the incoming PCN manager is being paid…

It is very difficult for an outsider to come in as manager and be effective straight away with a group of practices.  This requires trust, which needs time to build, and the covid restrictions make that all the more difficult right now.  It is hard to build relationships via Zoom.

Do PCNs really need a manager?  Is it worth the investment?

Many PCNs have been able to cope perfectly adequately without one until now.  Unfortunately this is no great indicator that this will be the case in future.  On October 1^st three new service specifications kick in for PCNs (care homes, medication reviews and supporting early cancer diagnosis), alongside the requirement for PCNs to offer a social prescribing service.  In addition, the new Investment and Impact fund (think PCN QOF) begins.

In six months’ time four more service specifications will need to be delivered, while at the same time PCNs will take on the responsibility for delivering extended access.

Many PCNs are currently recruiting an average of 10 staff, with another 6 or 7 to be recruited by the start of next year.  These staff will generate work, headaches and challenges (new staff always do), and someone will need to pick up the pieces.

Without a PCN manager, who is going to do all of this work?  This is without mentioning the plethora of system meetings (just say no), the data sharing and patient engagement requirements, and any local initiatives the PCN has committed to.  Is the PCN CD expected to do all of this in 2 or 3 sessions a week?  Or the PCN practice managers in their spare time?  I don’t think so.

If your PCN does not yet have a manager in place, the time has come to bite the bullet and recruit.  From October not having a PCN manager will cost more than having one.  Don’t put it off any longer.  Some practices might not like it, but the sheer scale of work means that PCNs will not be able to function effectively without one from October.