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PCNs report overwhelming concern over meeting expectations

Without more time, support and investment in primary care, government’s health pledges will be just a ‘pipedream’

Louise Prime

Friday, 17 January 2020

Without greater support and investment in primary care the government’s health commitments could be just a ‘pipedream’, the NHS Confederation warned this morning. It reported overwhelming concern that primary care networks (PCNs) – which are critical to the delivery of the NHS Long Term Plan – are far from prepared or resourced to deliver what is being expected of them in the year ahead, and primary and community services will continue to deteriorate unless these issues are addressed.

The NHS Confederation Primary Care Network said in today’s report* that there is a risk that the next 12 months will be ‘make or break’ for PCNs, which were established less than a year ago. It talked to people working across primary care and surveyed clinical directors leading PCNs – mainly GPs – to identify what they need most to meet the current pressures, transform services and deliver better and more joined up care for patients.

It found that the three most pressing priorities that NHS England and NHS Improvement must address for PCNs to succeed are time, support and funding. It said PCNs need to be given:

  • more time to build relationships and effectively prepare for new service specifications. Eight out of ten (81%) of PCNs said they need more time to develop the relationships between their general practices, and with community healthcare providers, to enable them to deliver what is being expected of them nationally, including the draft ‘service specifications’.
  • additional (protected) funding to enable them to employ management support, accompanied by support on issues such as workforce by CCGs and/or integrated care systems (ICSs). Nearly half (48%) of PCNs are confused about available funding and how it is allocated. And PCNs raised significant concerns about whether the draft ‘service specifications’ from NHS England and NHS Improvement, which will set PCN requirements for the next four years, are properly funded for what is expected of them.
  • Half (51%) of clinical directors who responded said that this is their first leadership role. Almost half (48%) of respondents said that without dedicated management support for PCNs, clinical directors will continue to be overburdened and unable to progress at the pace expected.

Ruth Rankine, development director for PCNs at the NHS Confederation, said: “The government has set out ambitious plans for primary care which recognises its vital role in the system, but this vision is at risk of being nothing more than a pipedream because the fundamental building block for this transformation has not been given appropriate time and investment.

“It has been only six months since PCNs have set up across England and despite the huge potential, there is overwhelming concern that they are far from prepared or resourced to deliver what is being expected of them. In particular, clinical directors have told us that they need more time, more support from their local systems, and greater clarity around funding for what is being asked of them.”

She added: “We welcome the positive signs from NHS England and NHS Improvement that they are listening to us, and to clinical directors across the country, and urge them to continue this engagement as a priority so that primary care networks can deliver real impact and be a valuable part of the local system. Without action, more clinical directors will walk away and the network model, and the ambition for primary care, faces collapse.”

The NHS Confederation, including NHS Clinical Commissioners, has launched a new PCN Network to provide a collective voice for PCNs across England and influence national policy and debate; it is working in partnership with the National Association of Primary Care, the British Medical Association and Royal College of General Practitioners.

NHS Confederation senior clinical adviser Dr Graham Jackson pointed out that although there are already many strong examples of PCNs flourishing around the country, there are also many clinical directors who are struggling and concerned about the sustainability of the model. He urged clinical directors to register their interest online in the PCN Network so that they can keep abreast and influence developments on “what could be the biggest opportunity for primary care in a decade”.


* NHS Confederation Primary Care Network. Equipped for success? What clinical directors need for effective primary care networks. NHS Confederation, Published online 17 January 2020.

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