PCNs are groups of general practices working closely together, with other primary and community care staff and health and care organisations, providing integrated services to their local populations.
From April 2019, the BMA’s GP committee and NHS England have agreed a DES (Directed Enhanced Service) to fund and support, individual GP practices to establish/ join PCNs covering populations of between 30,000 to 50,000 in England.
The BMA have created a handbook which provides advice and offers options 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; it is advisable to read the whole of the document before meeting with others to make decisions.
This handbook has been updated since publication and provides a list of amendments at the of the document.
Download the handbook
Read our PCN top tips
Aim of PCNs
The main aim of PCNs is to focus services around local communities and help rebuild and reconnect the primary healthcare team across the area they cover through the network, providing workload support for practices at the same time. LMCs and CCGs will work together to ensure practices will lead and direct these networks, it will help GPs and primary care practitioners to deliver a new model of care for their patients and communities.
The creation of PCNs is dependent on a number of factors, such as: Geography, a network agreement, the appointment of a Clinical Director and establishing and enabling sustainable networks. Go to page 3 in the handbook to find out more.
PCN conference for medical directors
The BMA, NHS England and GPDF are jointly hosting a conference for PCN (primary care network) clinical directors on 15 June 2019. Topics will focus on PCNs in the wider NHS system, PCN contractual requirements and PCN legal structures.
Find out more and register
In brief: PCNs
Internal governance and decision-making processes
Whichever organisational structure that practices chose to develop for their network, they will need to ensure that there are robust and appropriate governance structures in place. In doing so, practices will need to consider a number of key questions regarding how they wish the network to operate on a day-to-day basis.
- Governing/ Representative Body – this will help to set out a clear decision-making process, they will need to identify relevant agents to act on behalf of Network members.
- Decision-making – this process will need to cover what is in the remit of the Clinical Director, how decisions are made, how often the governing body meets and how these are chaired.
- Accountability – clear lines of accountability should be agreed and established from the outset.
- Data sharing – data sharing agreements will need to be set up between the constituent practices, as well as any non-GP organisations that are party to the Network, this is to allow all parts of the Network to access the necessary patient data.
- Dispute resolution – clear dispute resolution procedures will need to be in place to ensure disagreements are resolved appropriately.
- Finances – depending on how the Network is constituted, governance procedures should set out how the Networks finances are handled.
- HR policies – HR policies will apply to staff employed under the Network.
- Non-practice partners – Networks will need to consider how they interact with other healthcare bodies, in preparation for close working relationships that develop with other primary and community care organisations.
In addition to the workforce costs (for the additional workforce and the clinical director) each network will receive a recurrent annual payment of £1.50 per patient (an extension of the current CCG funding, but now non-discretionary) to be used by the network practices to support their work. Practices will also receive a separate payment through the SFE in return for signing up to the DES.
Front-loaded additional funding, ring-fenced for networks, will be available from central allocations (in addition to some of the current funding for GPFV and CCG funding).
A new Network Investment and Impact Fund will be introduced from 2020, tied to the development of community-based services that enable reductions in hospital activity, such as accident and emergency attendances, delayed discharge and avoidable outpatient visits.
Workforce and employment
Additional workforce will be introduced and partially-funded through the Network. The number will build up over the five years, so by 2024 there should be an additional 22,000 staff in primary care, as follows:
- From 2019, each network should be able to employ one clinical pharmacist and one social prescriber.
- From 2020, funding will increase to enable the additional employment of first contact physiotherapists and physicians associates.
- From 2021, all of the above will increase and community paramedics will be introduced.
- From 2022, all of the above workforce will be increased so that by 2024 a typical network will receive 5 clinical pharmacists (equivalent of one per practice), three social prescribers, three first contact physiotherapists, two physicians associates and one community paramedic.
There will be some flexibility around numbers and professions within networks.
NHS England will fund 70% of each professional including their on-costs. Networks will need to fund the additional 30% themselves. The exception is social prescribers, which NHS England will fund 100% including on-costs.
The network will decide how the additional workforce is employed (ie by a single lead practice, by an organisation (eg a Federation or community trust) on behalf of the network, or different professionals employed by different practices within the network).
The workforce and network will be led by a Clinical Director, chosen from within the GPs of each network. This Clinical Director will be funded – an average of a day a week for a network of 40,000 patients (including on-costs) from new funding provided by NHS England.
The wider NHS landscape
ICS (Integrated Care Systems) are a new 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 in an integrated way with other community staff and use integrated MDTs across primary and community care.
PCNs are central to the provision of integrated, at-scale primary care, encompassing services beyond core general practice and working closely with acute, community and mental health trusts, as well as pharmacy, voluntary and local authority services.
Webinars, resources and blogs
PCN toolkit and useful templates
PCN initial meeting considerations and template
Setting up a PCN checklist
Employers Advisory Service
The BMA’s Employers Advisory Service has draft contracts and employment policies which we can tailor to your PCN’s needs, for Clinical Directors, Clinical Pharmacists, Social Prescribers and Business/Operations Managers. Contact the Employers Advisory Service to discuss your specific requirements.
BMA Law PCN briefing
BMA Law bespoke PCN package
BMA Law locality pro-forma PCN package
Learning and development
The BMA supports the clinical and non-clinical learning needs of clinicians. We provide webinars, masterclasses, e-learning modules and coaching for clinical directors, including leadership and management, strategic planning and relationship management
See the latest opportunities
Join the PCN clinical directors forum
Join the forum
The BMA's primary care network support has a discussion forum, called a list server, for members to converse and share information. The forum is for those who are opting to become or have already been hired as a clinical director for their network and/or are leading the creation/development of the network. As a member of the listserver, you must observe agreed guidance for the use of listservers and other means of electronic communications, as set out in the BMA email guidelines, and BMA technology terms and conditions and GDPR guidelines.
Please note the forum is open to both BMA members and non-BMA members, until 30 June. As this forum is for setting up PCNs, on 30 June the forum will be shut down. At which point clinical directors who are BMA members will transition to a different discussion forum and will be notified accordingly. If you are a not a BMA member, to access the forum from 30 June onward you will need to join the BMA.
Please note the forum is open to non-BMA members until 30 June. On 30 June the forum will be shut down. At which point clinical directors who are BMA members will transition to a different discussion forum and will be notified accordingly. If you are a not a BMA member, you will need to join the BMA to access the forum.
BMA code of conduct May 2018
BMA committees email guidelines 2017
BMA committees technology GDPR terms and conditions
BMA confidentiality policy April 2018