If you are not familiar with shiny new toy syndrome, it is characterised by the sufferer wanting to own the latest toy and getting hooked on the intense but very temporary high of the ownership, before moving on to something else.  In the short term the new toy always seems to offer some sort of novel nirvana and the hope of short term gains, and the owner is blinded to the obvious shortcomings of that item.  But then, inevitably, disenchantment sets in, and the owner discards the toy and moves on to the next thing.

It seems to me that at present the wider NHS system is suffering from shiny new toy syndrome when it comes to Primary Care Networks (PCNs).  Whatever the current question, at present the answer is “PCNs”.  From “how will general practice be sustainable in the future?” to “how will we sort out out of hospital care?” and right through to “how will we deliver our ICP plan?”; the answer always seems to be “PCNs”.

As happens with shiny new toy syndrome, the system is apparently blinded to the obvious shortcomings of PCNs, most notably that they are brand new, they have very limited (if any) capacity to deliver, they have a large cohort of inexperienced leaders in place, and the relationships they have are very much in their infancy.  PCN development money is not, unfortunately, magic dust that can make these limitations disappear any time soon.

And it does not take someone with particularly well-honed psychic powers to predict that a year or two down the line widespread disillusionment with PCNs will set in, as they fail to deliver “what we expected”.  This will be followed by questioning as to whether the 30-50,000 population was really the right size, and then a new solution (or shiny new toy) will be put in place to replace this one, with equally unrealistic expectations upon it.

Success generally comes by staying focussed over the long term, and not getting distracted by whatever is new today.  The risk is that in the excitement of PCNs the recent good work that had been put in place to turn round the fortunes of general practice may get lost, including:

• The GP Forward View and the releasing time for care programme
• The support for individual practices to meet the challenges they face
• The support for practices to learn to work together in different ways
• The support for federations and other at-scale structures as enabling entities operating across multiple practices.

These were things making a difference, and you can feel the system losing its appetite to maintain its focus on them because PCNs are the shiny new toy in town.  Of course PCNs are an opportunity to build on the work so far, to enable further investment where it is needed into general practice, and to develop stronger relationships across general practice and between general practice and the rest of the system.  But it is going to take time.  The benefits will only come over the medium to long term, and they will require PCNs to build on the progress to the point at which they were conceived rather than starting all over again.

Right now what is important is that unrealistic expectations of PCNs are challenged both nationally and locally to give PCNs the chance to grow and develop.  The system needs to move away from shiny new toy syndrome and develop a long term commitment to PCNs as they have been configured, accept the real benefits will come some years down the line, and understand that the best way of accelerating this development is to build on the work already carried out rather than starting all over again.