The recent PCN guidance signalled a new phase for Primary Care Networks.  In a recent blog I examined the guidance in some details.  The upshot, though, is that delivery expectations on PCNs will increase significantly from the start of October, and then again from March next year.

Covid has directly impacted on PCNs over the last 18 months.  Amongst other it postponed some of the delivery expectations to allow practices to deal with the pandemic and to roll out the vaccination programme.  Meanwhile the ARRS investment has continued.  Now the transition from set up to delivery is happening very quickly, instead of the more gradual shift originally intended.

This is significant for PCNs.  It means a move away from considering how to best use the ARRS funds to requiring a much stronger focus on delivery against the DES specifications, the IIF indicators, and any local schemes that may be in place.

So the set up phase of PCNs is effectively coming to a rather abrupt end, and we are entering a new delivery phase.  How should PCNs respond to this change?  Here are my top 3 ‘Dos and Don’ts’ for PCNs in making this transition.

DO

1. Do be explicit about the link between PCN and Practice Work

Since 2019 the uplift in funding to the GP contract has come almost exclusively through PCNs.  This trend will continue for the next three years until 2024, and is highly likely to continue beyond that.  The funding and resources that will come to practices via PCNs will soon make up a key part of a practice’s income.  Participating in PCN delivery is not separate (and additional) to a practice’s core work; it is part of it.  For practices in a PCN to make the most of the PCN opportunity they need to work together, and make sure a commitment is in place from each practice to meet the delivery requirements.

2. Do firm up the agreement between practices in relation to delivery

It is crunch time.  Some PCN targets can only be achieved if each practice plays its part.  But what happens if one practice does not meet the delivery requirements?  What if that means the whole PCN loses out financially? What are the consequences?  How will the PCN respond?  Will the practice have to recompense the other practices for any income lost? How will it work? It is really important practices within a PCN have a clear upfront agreement in place of exactly what the requirements in relation to delivery are, and what will happen if these are not met.  Without these in place life could become extremely difficult over the next few months.

3. Do put management support in place

Many PCNs have some management support in place, but some still do not.  The latest guidance promises £43M for ‘PCN leadership and support’ this year.  If it is not already, ensuring delivery against all of the new requirements will be impossible for PCN CDs to do on their own from October, so use this funding to put some management support in place.

DON’T

1. Don’t Change PCNs

Being in a PCN can cause relationships to fray, and working together can sometimes feel more difficult rather than easier over time.  But if you have got this far with your PCN configuration don’t be tempted to change it now.  Changing PCNs means doing all the start up work all over again, and frankly there is not the time to do this as well as meet all the delivery requirements.

2. Don’t ignore the fact that a practice is not delivering

Conflict is difficult, and PCNs have been working hard to build relationships between its practices over the last two years.  But if a practice is not meeting its extended hours commitments or its care home requirements, and that is impacting the PCN as a whole, then it needs to be tackled.  Ignoring non-delivery now sends a message that non-delivery is ok to everyone, which in turn will make effective delivery across the increasing range of requirements almost impossible to achieve.

3. Don’t waste your time in pointless meetings

The value of PCNs will ultimately come from their ability to make a difference to their local population.  It will not be determined by the number of system meetings that the PCN attends.  This phase for PCNs requires an internal focus to make sure they are each able to deliver effectively.  A PCN’s influence will increase if it can gain a reputation as one that can make change happen, versus one that attends a lot of meetings with little end product.