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Cynics like me are I’m sure tired of hearing a new three lettered acronym every year and how it is going to save general practice! So, why then have we negotiated an enhanced service in this year’s contract which features investment to support working in primary care networks? Well, for a multitude of reasons really, and I hope the following explains our thinking.
First and foremost, the way the PCNs have been incorporated into the core general practice contract will give the ownership of ‘working together’ back to GP practices. Just to be clear, PCNs aren’t completely new. 88% of practices in England already work in some kind of network – like neighbourhoods, localities, federations or super-partnerships. The concept is not new, but the support and safeguards are, and that is what will make PCNs different to the previous TLAs.
Only GP practices can set up PCNs. The framework in which the PCNs operate should go some way to help alleviate workload pressures on practices and allow GPs to concentrate on caring for our patients at a local community level. We believe that this should happen with the support and backing of a robust national contract and that is why it is now a directed enhanced service.
PCNs will consist of a grouping of GP practices within a coherent geographical area, typically covering a population of 30-50,000 patients. Whilst the exact number is not something we should get fixated on, the underlying principle is that they should be small enough to still provide the personal care valued by both patients and practices, for practitioners working within it to have a reasonable chance of knowing the people they are working with, but large enough to have impact and economies of scale through deeper collaboration between practices and others in the local health and social care system. Practices will also have opportunities to collaborate with other local primary and community services as part of PCNs, and build relationships with voluntary, secondary and tertiary services. This gives GPs the opportunity to lead a renewed primary healthcare team.
There is now guaranteed, recurrent, national funding available to PCNs through the enhanced service to expand our workforce and reduce our workload. Commissioners locally are expected to supplement this and it is us, GPs, who will lead the networks to ensure general practice remains at the core of PCNs. Aspects of competition between providers will now be replaced with collaboration.
So, as a GP practice, do you have to be part of a PCN? The short answer is that you do not, in the same way that you do not have to take part in QOF. They are both voluntary. However the opportunities are not only of additional funding to deliver an expanded workforce, but just as importantly the ability to lead and shape community services in your area means this is something we would hope every practice would want to be part of. I would suggest that you consider the information that is available to you and discuss what opportunity this provides your practice and colleagues around you with your LMC. Richard, Mark, Farah and I will be doing GPC contract roadshows, hosted by LMCs in the coming weeks explaining the details of the contract. Please do come and attend these and share your thoughts with us.
The BMA’s initial guidance on PCNs can be accessed here. The BMA will continue to provide you with all the necessary national guidance in the coming weeks – please look out for these and discuss these in your LMCs about the local challenges and opportunities this brings you.
In the coming weeks, we will add more blogs on the following topics:
Great post,Thanks for providing us this great knowledge,Keep it up.
what about the real shark in the water....................ICP's