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PCNs (primary care networks) are about to be the new delivery of care unit in the NHS. At the helm of each PCN will be the CD (clinical director). This new leadership role poses many challenges, including formation and management of member practices, completion of legal schedules, providing services like extended hours and additional workforce, oh and fitting in with the wider landscape of the new healthcare structures of integrated care systems, places and long-term plans.
A true challenge, and one I have taken on for my network. So I was encouraged to hear about a national conference created by the BMA with NHS England to support the new cohort of CDs.
What follows is my reflections of the day. Shall we begin?
(You can if you would rather relive the conference via the medium of Twitter then see this link)
After registration networking began which involved 'meeting random people from the Internet' (WhatsApp PCN groups). For those that don’t know, there are multiple WhatsApp groups for CDs created by Nikki Kanani (contact her on Twitter - @NikkiKF or others like @cdspcn to get access). In my view this is far better in my view than the BMA listserver to support CDs (prevents email overload).
The networking opportunity was invaluable and hearing others’ challenges and accomplishments filled me with both enthusiasm and despair. One perfect analogy by Dan Bunstone was: 'it’s like going to the gym. There’s always someone fitter or slimmer or more muscular. Give it four weeks and it’s you.' However I would emphasise that you need to run your own race.
GP committee chair Richard Vautrey opened the conference after an introduction by workforce and PCN lead Krishna Kasaraneni. Richard briefly recapped on why networks were created and what they could achieve. This was further explored by NHS England national director for strategy and innovation Ian Dodge.
Following this, Douglas Moederie-Lumb of the GPDF explained what the GPDF was, how it is funded and how it had paid for the event. That was my take-home message anyway.
The last of the morning plenaries was a double act by acting (but needs to be official) director of primary care for NHS England Nikki Kanani and NHS England director of primary care delivery Dominic Hardy. They succinctly explained key points about PCNs and the visions and clarity on some of the rules. My take-home message was that being a PCN CD gives you the authority to be involved in the wider political landscape of place and system, but it is important not to try and do it all, especially avoid spending all your time in meetings.
A quick coffee break allowed me to catch up with a fellow Nottingham CD where we decided to tackle the workshops to ensure we covered varying sessions. I would recommend using this tactic for these type of events given the workshops were not recorded.
I attended the workshops on IT and data governance, building local relationships and collaborative working and QoF changes.
All the workshops had knowledgeable speakers with detailed and useful information and facilitation which I appreciated. In particular, the QoF session facilitated by representatives from NHS England and the BMA showed collaborative working with a respectful relationship and clear knowledge of the topic. This was the most impressive and important factor for me in this conference; getting a decisive answer on the spot.
My impression from the delegates was that there is a lot of enthusiasm but also anxiety over managing the changes and particular deadlines for PCNs.
This was evident in the IT and governance workshop. The sheer frustration and anger shown by delegates on the lack of promised data sharing agreement templates was clear. Delegates in our session were told 'it is with the relevant person and they should have them ready in about two weeks'. Recognition that this would give CDs about 10 days to complete these agreements sparked challenges to delay submission of the agreements, given what appeared both incompetence and audacity of NHS England to not abide by deadlines but expect primary care to. It reminds me of the saying ‘do as I say, not as I do’. Farah Jameel promised to represent this challenge back to the relevant departments.
Another recurring theme was that collaborative working will be key, not just with fellow practices but with other providers, the voluntary sector, social care and anyone who wants to help, in effect working towards community rather than practice care. Connecting, sharing and collaborating will stop networks from becoming silos that will fail.
In between the workshops we had a contractual session. This was helpful to understand the changes the contract offered with a focus on the network DES. The use of examples for funding was a welcome change. This along with the other plenaries should be available for later viewing on the BMA website.
The day concluded with a Q&A session with the headline speakers. In total 13 questions were asked, and all were given a clear answer. Again, having access to those who had answers to our questions was the most valuable part of this conference. I would suggest the BMA publish this session as FAQs.
In summary, the venue and organisation were great. My only criticism was the lack of planning for the demand for this event. This could be tackled by making all the sessions available online – a key message for all engagement events like this. The content was supportive and informative with a clear message from both NHS England and the BMA that they want to be helpful, with only a few instances of ‘ivory tower’ control through the day (less than I anticipated). The best aspects were the instant information and the networking which provided key support for me (and feedback from others) to tackle this new role.
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