General Practitioners Committee England

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Primary Care Networks (PCNs)

PCN timeline 16x9 v2

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.


PCN handbook

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

PCN planning calendar (PDF)


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.


Creating PCNs

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 clinical directors conference

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.

Watch the recording of the event


PCN masterclass: leadership through change for aspiring clinical directors

The BMA and GPDF are jointly hosting 2 half day masterclasses on 18 June in London for PCN (primary care network) clinical directors on leadership through change. 

These masterclasses are aimed at those aspiring to the role of a PCN clinical director and have been designed to support you as you transition into your new role.

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.
  • Funding

    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.

    Social Prescribing: Making it work for GPs and patients

    Download the guidance

  • 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 other useful documents

    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


    Tax guidance

    When developing their PCN practices will need to be very careful that the structure they choose does not inadvertently attract VAT charges. To help guide initial discussions and future considerations for practices, The BMA commissioned these guides on the potential VAT considerations of two of the most common models of PCN; the ‘lead practice model’ and the ‘federation model’. Further information on these models are available in the BMA’s PCN Handbook.

    The information contained in these notes is intended as general guidance and prepared for information purposes only. It is not intended to provide financial advice. The advice and information which MHA Larking Gowen has provided to BMA is for BMA’s sole use and not for any third party to whom BMA may communicate it unless we have expressly agreed in our letter of engagement that a specified third party may rely on our work.

    Neither MHA Larking Gowen nor the BMA accept responsibility to third parties to whom this engagement letter is not addressed, for any advice, information or material produced as part of our work for BMA which is made available to them.

    VAT and PCN funding for GP federations

    VAT and PCN funding for Lead providers


    Decision-making guidance

    The following documents have been created to assist the decision making for the network agreement schedule 1 part 7. Example 1 is a simplified version which covers decisions to be made by core network groups. This document indicates that each practice will nominate a practice rep who, together with the Clinical Director, will sit on the executive team.

    Download PCN decision making guidance 1

    The more detailed version, example 2, also covers decisions by practices, all members and an operational committee. The idea being that the operational committee handles day to day operations/running, the practice committee take decisions of the core network practices and the member committee take decisions of all members.

    Download PCN decision making guidance 2

    We recommend that you carefully read through both documents and note that these are indicative provisions, so we cannot guarantee their suitability to all practices.


    Guidance for sessional GPs

    Downlaod guidance for sessional GPs

  • 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