What is a Primary Care Network? Well? What would you say? It is a question that should be simple to answer, but in reality is not. According to the NHS England website, “They consist of groups of general practices working together with a range of local providers, including across primary care, community services, social care and the voluntary sector, to offer more personalised, coordinated health and social care to their local populations”. Is that what you were going to say? I didn’t think so…

The NHS England definition feels more like an ambition than a definition. Technically, today, a Primary Care Network is a group of GP practices who have signed up to the Network Contract DES, and who as a result have a Clinical Director and a network agreement in place between the practices. And, as the Network Contract DES Specification states, “There is no requirement for the Network Agreement that is signed by 30 June 2019 to include collaboration between practices and other providers, but this will need to be developed over 2019/20 and to be well developed by the beginning of 2020/21 when the Network Agreement will need to be updated to reflect the new Network Contract DES specification.”

Why have GP practices joined primary care networks? Of course for some it is the opportunity to deliver coordinated, integrated care for the local population, but for most it is because access to much of the financial and workforce resources in the new GP contract is dependent on joining. There is an expectation that up to 40% of the additional funding for general practice will come through the new networks, and as the GPC’s initial press release about the new contract said, “Support and funding for Primary Care Networks mean practices can work together, led by a single GP, and employ additional staff to provide a range of services in the local area, ensuring patients have ready access to the right healthcare professional, and helping reduce workload pressures on GPs.”

So we are in this strange limbo position whereby the NHS has introduced Primary Care Networks and created a rhetoric around them that they are to do one thing (co-ordinate and integrate care for local populations), but an establishment of them where the on-the-ground reality is about GP practices working together to secure the investment and resources they need to survive.

This, inevitably, is leading to confusion. The wider system is somewhat bamboozled by Primary Care Networks and the conflicting messages about them, and as a result has no idea what to make of them. “PCN” is being added to the list of acronyms such as QOF, PMS, GMS that make general practice so inaccessible to outsiders. Even practices themselves are not sure whether to keep the PCN at arms-length, and insist that PCN services are kept distinct from the services provided by individual practices, or to embrace the opportunity for cost-saving, income generation and workforce development that PCNs could potentially provide.

But in the midst of this wider confusion there is huge opportunity for practices. If practices can maintain clarity on exactly what a PCN is (as defined by their contract), keeping in mind that the contractual requirements will change and evolve, it actually puts them in a strong position. They can focus on maximising the opportunities of PCNs for their practices for now, and on ensuring that as the system asks for more from PCNs (as it inevitably will) that appropriate funding follows.