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A week on from the contract announcement, I am sure colleagues would have been approached by all sorts of organisations offering you help to set up PCNs. Let me therefore start with the obvious stuff. The detailed documents and specifications are being worked up at present and will be released once completed. Therefore, please do not get sucked in by these offers and reach for your wallets because you will be paying for a product that at best doesn’t exist, or at worst is actually not what you need at present.
So, what do you need to consider at this stage with respect to the structures of the PCNs? The first place to start is to look at the structures that you already operate in, or operate near. 88% of practices already operate as a part of a network of some description. Acknowledging that these will be at various levels of development and of varying sizes, some of you may decide to continue with the same structures and some will want to reorganise yourselves. The remaining 12% of practices will be starting from scratch. If you find yourself in that position, engage with practices around you and start exploring if there is a potential opportunity for you to join a network close to you. Irrespective of where you find yourself in that spectrum, please familiarise yourself with the following before you take any actions:
It is natural to have some concerns about what form your PCNs should take and your first port of call after you’ve considered the above three documents is your LMC. Discuss your thoughts about how you see your PCN developing and make your LMC aware of your concerns and potential challenges. Your LMC will be involved in local discussions with the CCG and consider the local GP landscape and represent your thoughts locally to the commissioners.
This brings me on to the different ways you can organise yourself. There is simply no specified structure, legal or otherwise for the PCN to adopt in order to sign up to the DES. All that is required is that the member practices meet the network registration requirements. These were outlined in the contract document, and further detail will be made available to you by the 29th March. So, if you start having an initial conversation with your surrounding practices now, you will then have a relatively short window (that closes on 15th May) to submit your registrations.
Depending on how PCNs evolve and how they are supported locally by commissioners, different PCNs may take on different forms at various stages of their evolution in the future. There will be many aspects that will need to be considered as PCNs develop, to make sure the form follows the function of what you are trying to achieve locally. These could be VAT implications, human resources, leadership development for PCNs amongst other things. The BMA will provide guidance on all these areas and more in the coming weeks, so keep an eye out for more support from us.
Richard, Mark, Farah and I will be doing a large number of 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.
In the next few weeks, we will add more blogs on the following topics:
So, if I may leave you with one message - next step is to start thinking about how your PCN could shape up and contact your LMC.
Krishna Kasaraneni is a member of GPC executive
do they population sizes need to be 50000? the original plan was 50-100,000?
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