As we come to the end of the third year of the PCN it is a natural time to review how things have gone so far, and to consider what might need to be different going forward.  But how do we know how our PCN is doing?

I am struck by the number of PCNs that tell me that they are “behind other PCNs”, even when to me they seem to be extremely well.  Sometimes we hear success stories from other PCNs and assume that this is what “everyone” is doing, and that we are somehow falling behind.  But PCNs are not a race or a competition, and it is up to each PCN to determine what success looks like for itself.

I wrote last time about the importance of a PCN vision, and the need for the practices in a PCN to set their own direction to determine what they want from the PCN.  One measure for how well we are doing is the progress we are making against our own priorities for the PCN (which may well be different from those of other PCNs).

But it is not the only measure.  At their core, PCNs are a joint working initiative across the member practices.  Whatever desired outcomes the PCN has set, a key metric for any PCN is the level of trust that exists between the members.  The more we trust each other, the easier working together becomes.  And this is where we get into the importance of the culture of the PCN.

When you ask member practices about the PCN and how well it is doing the response is rarely about whether the PCN is achieving its goals.  Instead the framing of the response is often about how involved they feel in the work of the PCN, its relevance to them, and its impact (positive or negative) upon them.

So while in part the response is about the level of alignment between the PCN’s goals and the practice or individual’s goals (e.g. is it reducing or increasing my workload), it is also about the way the PCN operates.  Do member practices feel involved in decision making?  Do they feel able to shape the activities of the PCN?  Do they know what is going on?

This is essentially what the culture of the PCN is – “the way we do things around here”.  If the culture is strong, is built on a solid and developing foundation of trust, and the member practices are happy with it, then the PCN has a solid foundation to go on and achieve whatever it wants to in the years ahead.  But if there is unhappiness with the culture, complaints about the lack of communication, disengagement from practices, and a general lack of trust, then regardless of what has been achieved so far it is likely to be a difficult road ahead.

Determining how well we are doing in a long term joint working enterprise like a PCN needs to be as much in terms of how we do things as what we have achieved.  If we are taking time out to take stock of where we are as a PCN (and I strongly recommend that you do!), then make sure to spend as much time on how the PCN is working as what you want it to achieve.