General practitioner England

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The explainer: PCNs

Patients in GP waiting room6 16x9

Primary care networks are being set up to promote integrated care. What will it mean for GPs?

What are they?

PCNs are groups of GP practices working collaboratively in a formalised structure, typically covering a population of 30,000 to 50,000 patients, and combining with other primary and community services and local organisations to ensure an integrated approach to health and care for that population. It is expected that all areas in England will be covered by one by July.

Why are they being established?

The intention behind establishing PCNs is to focus services around local communities, building on local GP practices to help rebuild and reconnect primary healthcare teams across the areas they cover through the network.

The BMA GPs committee negotiated a new directed enhanced service with funding entitlements in this year’s contract to fund PCNs because the ownership for leading local services should sit with GP practices. Only GP practices can set them up. It is hoped they will alleviate workload pressures and allow GPs to concentrate more on the most complex patients.

Aren’t there already networks?

Yes. In fact, most practices in England work in some kind of network. The difference is PCNs have the support and backing of a national contract and formalise the establishment of networks in a consistent way.

Will they offer new services to patients?

Yes. From 2020 there will be the potential for additional funding of new services in line with the aims set out in the NHS Long Term Plan. These include medications review, supporting early cancer diagnosis and cardiovascular disease prevention and diagnosis.

What kind of funding will be available?

There will be payments to practices for engaging with PCNs, and other payments direct to the network as entitlements; some are ringfenced (eg for a clinical lead and a contribution towards new staff costs) while other payments are for networks to decide the use.

How much flexibility will be permitted on the size?

The thinking is that the practitioners involved will still have a reasonable chance of knowing the people they are working with, but that PCNs are large enough to have an effect and make economies of scale. However, if practices think they have a good case for forming a larger or smaller network, they should make it to their CCGs (clinical commissioning groups).

Could a large practice be a network in itself?

Yes, particularly those practices which have 30,000 to 50,000 patients and cover multiple sites within a geographical area.

What happens now?

Practices are being urged to talk to their neighbours about forming a network. Local medical committees are in an ideal position to coordinate and mediate where necessary and the BMA will provide advice and guidance. The new PCNs will submit registration information to their CCGs by the middle of May, with CCGs confirming the network coverage by the end of May. They are planned to go live in July.

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