- Posted Wednesday November 27, 2019
Several months after the official formation of Primary Care Networks, it seems a good time to review how things are going.
I can understand the ideology behind the networks and I support the plans up to a point, but I still have reservations. I can’t help but think we are all trying to re-invent the same wheel across the country, and that (ironically) there should be more joined-up thinking to help us solve the various issues we all face.
Our PCN is meeting fortnightly and have started to look at ways of working more closely together. I have previously mentioned that there are tensions between some members but slowly, slowly, the will to succeed means we are overcoming some of these issues.
Issues around sharing personal data
We have a consultant working for us two days a week and in my opinion this has been essential, as they bring to the table many thoughts and ideas from organisations across the country.
I have one particular gripe with the service at this stage however - how much individual data each practice is being asked to share. Now I know that we have to do regular returns of staffing on NHS portals, but we are being asked to give our consultant more personal details such as ages and salaries, which extends to salaried GPs and partners.
We have been assured this data will not be divulged to the other practices in the PCN. However, despite being told it is essential, we remain sceptical as a practice and have caused issues by not sharing these details at this stage. What would you do?
Tackling confidentiality and GDPR compliance
The key to our reluctance is that we feel sharing details about peoples' ages could be ageism, and that giving some other details would breach GDPR unless we can get written permission from our staff.
We are not prepared to share the information at this moment, as I feel it could upset staff and leave them uneasy about the reasons behind the data being shared. Having spoken to some staff members to gauge their reactions, I found I was correct with my assumption.
I have provided anonymised details, including hours worked, but nothing identifiable - only the details given to the NHS. Speaking to other PCNs in the area, I learned they have not been asked for such data - nor would they share it.
The potential of sharing staff and resources
We have had joint meetings with all the staff in the area, and new staff have a clause written into their contracts saying they may be asked to work elsewhere in the area in the future. We are looking to next April when the new DES comes into play and we hope to be ready to take any opportunities that present themselves.
Unlike some others, we are very early into the planning process and we accept that it looks as though the eventual long-term aim is to amalgamate practices into 50/60,000-patient organisations, which could benefit from economies of scale.
I am really not so sure as to whether this will ever be the case as, unless there is funding for super practice buildings, I believe economies of scale will be very limited. On the other hand, having huge practices in one building is really not in the patients’ interest as many will have to travel further to be seen and the personal touch will be lost.
The more things change…
So, the next few months will see more challenges and changes and we will need to adapt as always. With the imminent General Election, it could all just change yet again.
I think the biggest issue at the moment is how the five new DESs will work next year and the funding of the new roles being brought in, bearing in mind they have to be new positions and funded by the PCNs - with a 30% contribution from practices.
It is not clear how this would work in practice… and does the 30% include NI and pension contributions or is this just another added cost?
I am not optimistic that the funding we are getting is correct as only this month our CCG advised us that the calculations made were wrong and extra payments have just been made.
So, we are watching and waiting and will need to react as and when we get more details.
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