It is always an interesting to hear the response when I ask the leaders of any PCN whether they have a PCN vision.  Most commonly they recall doing some work on this a few years ago when the PCN first set up, but equally could not tell you what it is.  So is it time to revisit the PCN vision?

The problem is most of the work that goes into establishing what the PCN vision should be focusses on the words in the vision itself.  PCNs end up with some form of ‘vision statement’ that acts as the end product to the work, which is often some noble statement about supporting people to have better outcomes and working in partnership (etc).  But what happens to it, other than it ending up on the PCN website or being used as evidence in the latest PCN maturity matrix assessment?

It is not a surprise, then, that members of the PCN cannot remember what the PCN vision is, because its relevance to the members is limited at best.

The point of a vision statement is to establish why you are undertaking the enterprise in the first place.  Why has each practice signed up to the PCN DES?  What do we want out of it?  What problems are we all experiencing that we think the PCN may be able to help with?  If the vision statement can get to the heart of this, it becomes much more powerful.

The simpler the PCN vision is the better.  Compare these two PCN vision statements (these are real, anonymised PCN vision statements):

• Member practices of XXX PCN will work together to improve access to the local community. Extending the range of services available to them, by helping integrate primary care with wider health and community services. We will work in collaboration with others – health and social care services, the voluntary sector, community groups and local people – to make best use of available resources, creating a seamless approach, whilst making sure that everyone gets the right support, in the right place, at the right time.
• To create a sustainable future for our practices.

Which is most powerful?  The point of a vision is not that it creates a statement that everyone can sign up to (but ultimately can’t remember), but rather acts as the guiding force behind the decision making within the PCN.  The vision tells us where we are going, and everything else we do should fall in line behind that.

This is why having a clear vision for the PCN is really important.  If we do not have a shared vision across our practices of why we are participating in the PCN in the first place, then we have no clear point of reference for our decision making.  In the absence of our own direction, we let the PCN DES itself dictate our actions.

The PCN DES is produced in a way that enables the general practice leaders that negotiated this additional funding and resources for general practice to justify the investment.  The additional £2bn that it brings has to come with an output, and so those in charge can point to things such as its contribution to the long term plan (the PCN DES specifications) and enabling general practice to work within the integrated care system.

But that does not mean that this has to be how it is used by practices.  While the contractual requirements are there, what practices need to do is work out how they want to make the most of the opportunity that it brings.  Practices can set their own goal or goals, and then the challenge is to work around the contractual requirements to achieve these goals, not simply provide what others want.

If you do not know what your PCN vision is, now is definitely time to take stock and consider what you want it to be.  If you don’t, you are defaulting to a position where others are effectively deciding what you do (because you are simply led by the PCN DES requirements).  Take the time to come up with more than a statement that everyone will agree to. Come up with what you all want to achieve, and that can guide your collective decision making and actions going forward.