While many have sat back and breathed a collective sigh of relief that the 15^th May deadline was met for the submission of the initial PCN returns, that was unfortunately only the start of the journey.  Some pretty formidable challenges lie ahead.

I am sure some PCNs have a clear plan and are meticulously ticking off actions and making sure everything is sorted as they get ready for the 1^st July, when PCNs formally begin.  This is less for those PCNs, and more for the time poor and those who have that feeling there is something they should be doing but they are not sure exactly what! It also doesn’t cover everything you could be doing (if that’s what you need do watch out for Clare Allcock’s wonderful advice on how to accelerate collaborative working in next week’s podcast).  Rather this is designed to help you meet the minimum requirements.

Essentially, each PCN has to complete three key actions by 30^th June:

• Agree how extended hours will be provided at a rate of 30 additional minutes per 1,000 registered patients to all registered patients within the PCN.
• Ensure appropriate data sharing agreements and, if required, data processing arrangements are in place, using the national template, to support the delivery of extended hours.
• Ensure the network agreement is completed (including all seven schedules), and signed.

For the provision of extended hours, each PCN will need to know:

• Does each member practice wish to undertake the delivery of extended hours for their practice population?
• If any practice does not, is there another practice willing to take the delivery of these hours on?
• If not, is there a third party who can deliver the services on behalf of the practices?

It is easiest if each practice does their own extended hours, next easiest if there is some sort of buddy arrangement between practices so that they can cover each other, and least easiest if you have to create some new model of joint working across practices.  That is not to say one model is better than the others, only which is easier in terms of the amount of work each will require in the month until the next submission is due.

Now you may be lucky and already have data sharing agreements in place between your practices.  If you don’t, then there is the promise from NHS England of a national template.  Unfortunately, the PCN frequently asked questions states that this is not yet available as it has to be agreed with the GPC.  Watch out for its publication, as you are not going to have long to turn it round and get it agreed by your member practices.

As for completing the network agreement, remember the starting point for each PCN is the mandatory network agreement (here).  This mandatory agreement cannot be altered.  However, there are 7 schedules where additional clauses can be added.  The template for completing the schedules can be accessed here.

I am not a lawyer, so this is not legal advice, but if you had to prioritise you could go with the suggested wording of the national agreement and not worry too much about schedule 2 (essentially this schedule is where you can make changes/additions to some of the mandatory network agreement), and for schedule 6 you could go with the suggested list of insolvency events (it is essentially a list of different events of insolvency that would enable members to take action under the clauses).  The difficult bits you would then have to sort out are:

• The rest of schedule 1 (you have already done some of it) where you have to say how the meetings will take place, what is quorate, how you will make decisions etc etc
• Schedule 3 where you outline everyone’s responsibilities in delivering extended hours
• Schedule 4 where you have to outline all the network’s financial arrangements (how much money each practice is getting and who is going to pay it)
• Schedule 5 where you set out the arrangements in the PCN for engaging or employing staff, including arrangements for employment liabilities
• And schedule 7, which is essentially how you will work with any other organisation (e.g. a federation). Top tip here is get them to draft it for you, and then change their version, rather than starting with a blank piece of paper.

I don’t know how many meetings you are realistically going to have with your practices between now and the end of June, but if it isn’t many you may want to find someone to draft a starter for 10 for each of these schedules.  If you can agree 90% of them remotely, then you can use any valuable meeting time to focus on the hopefully small number of areas that are left.

And once you have done all that, you are probably going to need to get a lawyer to look over the final agreement with all its appendices before you can persuade your practices to sign it.   Remember the submission of the network agreement is due by 30^th June which (inevitably) is a Sunday, which means the 28^th June, which means there is only one month to go to get everything done.  No pressure!

What would be really helpful would be sharing across PCNs of good ideas for improving the agreement between practices, strong additions to the network agreement, and good wording for the schedules.  Anything we find along the way we will definitely pass on.

I hope that is useful.  If you have any advice for over-stretched incoming PCN leaders that I have missed please do get in touch to share.  Good luck all!