Primary care networks – what does it mean in practice?
Over the last couple of months we have attended a number of healthcare events and conferences, including Management in Practice, Urgent Health, RCGP annual conference and one thing that has been quite striking is the number of people talking to us about their uncertainty over primary care networks (PCNs).
In this blog we thought we’d look at the expectations that have been set for PCNs and a few examples of progress being made across the country to help us understand the expectations and see what the future might look like.
It has been reported that 99% of GP practices have now signed up to a PCN, creating around 1300 networks. It is clear from these numbers that the scale and complexity of the task in hand is not necessarily going to be easy. There are high expectations and so much appears to be unclear and has the potential to go wrong however we believe that it presents a great opportunity to;
- ease the gaps in workforce through broader team working and creating a more sustainable workload spread across a range of providers. It is hope this will in turn lead to a happier workforce
- help integrate primary care with community care
- play a role in population health (see our previous blog) through better targeting of patient care to help demand and cost
and of course
- improve outcomes for patients.
Timescales July 2019 to April 2020
The period from now up until April 2020 is a critical time for providers to get set up and prepare, in partnership, for the forthcoming national specifications, which will require joined-up delivery. The priorities include delivering extended hours access, working in multi-disciplinary teams with other providers and looking to improve urgent care responsiveness in the community.
In return the NHS England has promised to communicate upcoming PCN requirements and to provide guidance to PCN leaders to ensure they know what they need to do to get funding. We have heard that it is slowly becoming clearer what GP practices need to do to get paid.
We’d be very interested to hear about your thoughts and experiences on all of this. We’ve read quite a few things, in addition to conversations with people that refer to a lack of communication and understanding of progress expectations. There is guidance available and we would be more than happy to point you in the right direction.
- the recent NAPC annual conference, we heard about some amazing examples of progress in PCNs. One of them was Frome primary care home, which is a
well-established primary care setting with an enhanced model of primary care. In recognising the needs of its local population, the practice decided to set up a ‘care coordination hub’ to help vulnerable and socially isolated people with more than just medical care. The hub consists of GPs, district nurses, health visitors, a pharmacy, opticians, physiotherapist, and operating theatre. They have been working collaboratively now since 2013 and have seen a drop of 17% in emergency admissions during that time. They have also partnered with the local council to bring in people to help the community with other aspects of their lives.
Another example from this conference is Eden primary care home in Cumbria, who has worked with their patients and communities to overcome the particular challenges of rural living and high levels of fuel poverty. They have formed an ‘integrated care hub’ by bringing together community health teams, adult social care, the council and local voluntary organisations on one local community hospital site and are all working effectively together to improve the care for their patients and wider local communities.
It’s definitely worth reading about some of the trailblazing PCNs to see how and what can be achieved. Alongside this it’s probably worth bearing in mind some of the advice recommended by the NHS, especially if you are a provider. Be patient, don’t panic, protect relationships, be proactive, think about culture, design a practical support offer and above else be collaborative.
Here's how we can help;
NHS Providers/NHS Confederation – Primary care networks: a quiet revolution (July 2019)
The King’s Fund – Primary care networks and community health services: further, faster