PCNs are groups of GP practices working closely together - along with other healthcare staff and organisations - providing integrated services to the local population.
Since April 2019, individual GP practices have been establishing and joining PCNs covering populations of between 30,000 to 50,000 (with some flexibility).
How PCNs fit into the NHS structure
ICS (integrated care systems) are a way of planning and organising the delivery of health and care services in England at a larger scale than PCNs.
Every ICS will have a critical role in ensuring that PCNs work with other community staff and use multi-disciplinary teams across primary and community care.
Guidance on running a PCN
The handbook is currently being updated to reflect the updated requirements for 2021/22 and the development in PCNs over the last 12 months. This will replace the 2020/21 version available below.
The BMA has created a handbook that provides advice to groups of practices looking to establish a PCN.
Most of the major elements are inter-dependent and so conversations and decisions should not be made in isolation.
You should read the whole handbook (including the amendments at the end) before meeting with others to make decisions.
Since April 2020, auto-enrolment has been included in the DES. This means practices and PCNs do not need to submit anything to their CCG to confirm their acceptance of the revised terms and future years’ specifications.
If a practice does not want to continue participating in the DES, it must inform its CCG of its decision to opt out within the specified opt out window.
Opt-out windows will be open for 30 days whenever revisions are made to the DES specification. Most commonly, these will occur around the time of annual contractual updates in April. However, they may also take place mid-year, if changes to the DES are agreed outside of the annual contract negotiations.
NHS England and the BMA have agreed on a data sharing template for use by PCNs.
To make things simpler for practices, we have also produced a version of the agreed template which expands on a number of areas with greater detail, along with guidance on the document.
These do not constitute legal advice and you should seek professional advice when completing the agreement.
When developing a PCN, practices will need to be very careful that the structure they choose does not attract VAT charges.
To help guide discussions and future considerations for practices, we have produced two guides on VAT considerations of two of the most common models of PCN; the 'lead practice model' and the 'federation model'.
NHS England aim to recruit up to 1,000 link workers by 2021, who will be directly embedded within PCNs.
This guidance is to help GPs make the most of the social prescribing schemes they refer patients to and learn how best to work with link workers.
This guidance provides advice to GPs, practices, PCNs, LMCs and federations on engaging with sessional GPs and ensuring they are represented in PCNs.
Additional service specifications
There were four additional service specifications due to be introduced in April 2021:
- personalised care
- anticipatory care
- tackling neighbourhood inequalities
- cardiovascular disease diagnosis.
It’s been agreed between the BMA and NHS England that they will be delayed, as practices and PCNs prioritise their response to the pandemic and the vaccination programme.
Practices will be informed once the service specifications and their date of introduction have been agreed.
The four PCN services introduced as part of the DES in 2020 will continue unchanged. These are:
- extended hours
- early cancer diagnosis
- enhanced health in care homes
- structured medication reviews.
View the full service specifications from NHS England.
View more on PCN funding.
BMA services for PCNs
As sole negotiators of the GP contract, the BMA is in a unique position to understand the challenges clinical directors face.
We provide a range of expert PCN services and knowledge to support you with running a successful PCN.
If you're a clinical director or are involved with the running of your PCN, register your interest to sign up for any of the services or resources below and any in future.
BMA Law's team of specialist solicitors are on hand to help you navigate the legal process of running a successful PCN. Their solicitors understand that every PCN set-up is unique and all face different legal challenges.
To ensure you receive the support you need, they offer a variety of flexible, cost effective service options that are tailored to you; from network agreements to practice premise contracts.
Register your interest for more information.
The formation of your PCN brings new challenges to ensure you are properly protected.
With Lloyd & Whyte, you’ll have the cover you need, tailored to your PCN. No two PCNS are the same and the issues you face will vary, which is why Lloyd & Whyte make sure your cover is bespoke to your circumstances.
The PCN insurance package can cover:
- directors and officers insurance (particularly covering clinical directors)
- employment practice liability (eg claims of unfair dismissal)
- professional indemnity
- employer's liability and public liability insurance – to cover any gaps for those working on behalf of the PCN, across practices.
Register your interest for more information.
As part of BMA membership, clinical directors who are BMA members can access HR and employment law advice for their PCN by contacting the EAS (employer advisory service).
We have developed a PCN community app. Register your interest to get access.
- The latest PCN news, information and guidance at your fingertips.
- Connect and engage with fellow clinical directors.
- Leverage the experience of the BMA and PCN community to guide you to PCN success.
- Start conversations, ask questions and share your experience all in one place.
- Be the first to know about the latest information and updates from the PCN experts who negotiated the contracts.
In early June 2019, we held the first PCN clinical directors conference.
The day was attended by over 250 newly appointed clinical directors who received talks from GPC and NHSE negotiators, and workshops from experts covering a variety of topics.
We're here to stand up for your rights, support you in the workplace and champion the medical profession.