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What are the biggest issues surrounding Primary Care Networks?

Primary Care Networks are one of the hottest topics in healthcare, and as we all get used to this latest shift in the NHS landscape, there has been a lot of confusion around the finer details.


We asked professionals with extensive experience in the practicalities of establishing and sustaining a successful PCN for their view on the most pressing issues surrounding Primary Care Networks.
 

How are Primary Care Networks affecting you?

“The most pressing issue for general practice around the formation of PCNs is delivering the requirements of the DES whilst balancing the expectations of the member practices, their patients and the CCG and/or ICS.

The resources in terms of time, funding and management support are limited, and PCNs need to use them to the best effect, balancing the need to be sufficiently inward-looking to ensure that all members of the primary care team are fully engaged, and outward-looking enough to deal with the pressures of other provider organisations competing in an increasingly political environment.”
Dr Kevin Barrett, GP & PCN Clinical Director


The structure of Primary Care Networks

“The crucial decision for us was on deciding how the network is constituted, i.e. is it using a ‘lead provider’ model, where one practice employs staff on the network’s behalf or is it using a ‘flat’ model where employment is shared among member practices.  

Once this was established our focus is now on delivering new services with new staff in new roles.  Issues such as how we decide what HR polices apply to staff employed under the network, policies that must take into consideration peripatetic and pro-rated sessional working. 

How do we decide where to place ‘hubbed’ services that may require additional funding from the other practices or the central PCN pot and how we develop and manage expanded practice-based and connected teams to incorporate social and community provision?”
Mairead Roche, Practice Manager


Understanding the financial side

“General Practice needs to rapidly understand that PCNs are a key building block of all future health and care services. Whilst PCNs are obviously also a funnel for much needed additional resources into General Practice (and be aware that this may soon include premises funding), the key function of PCNs is to organise all local health and care services around their defined group of 30-50,000 patients. The role of the Clinical Director will be critical in this.

If PCNs fail to start reorganising local health and care systems then they will be missing a huge opportunity and I would also predict that the promised additional funding will, over time, dry up. I would therefore hope to see that PCNs rapidly move on from being all about the Core Network Practices, and start admitting other Members who provide services to the local community”
Nils Christiansen, DR Solicitors


“The lack of clarity in regards to the best operating models and the myriad of conflicting views has certainly added to the quagmire of confusion. It would certainly appear from a VAT and PAYE point of view little thought has been given to the potential implications of these taxes, which may leave PCN organisations in a difficult position once HMRC start knocking on doors”
Phil Harnby, Mitchells Grievson Chartered Accountants

 


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