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4 Top Tips To Help You Implement The Directed Enhanced Service (DES) in Your Primary Care Network

Updated: Dec 20, 2022

I was recently contacted by a PCN Manager who shared that they were looking to become more effective in implementing the primary care network (PCN) DES.

I have been fortunate to work with multiple PCNs providing interim PCN management and consultancy. This has welcomed the opportunity to share my insights in webinars and the THC Primary Care blog, where we have published over 200 articles, through which we are helping networks recruit PCN Managers.

I have learnt that whilst the PCN DES is hugely important, it is not just the technical side that the PCN managers need to pay attention to, although we will cover this aspect in this blog.

If you genuinely want to support your network to deliver on the DES, you must also invest in:

  • Relationships

  • Understanding general practice

  • Our personal development

Here is my take, so let's jump in ….

1. Prioritising relationships

To become more effective in delivering the DES, my first recommendation is to prioritise building relationships with your practices. This is key.

I believe that being a PCN Manager is about people. It is about building the know, like and trust factor. Please do not underestimate this.

If people do not know, like or trust you, your well-meaning efforts will be wasted.

Many of you will have heard of the book, How to Win Friends and Influence People by Dale Carnegie. If you haven’t, I strongly recommend you read this book. And if you already have it, read it again. Also, read How to Win Friends and Influence People in the Digital Age.

These books will help you to understand that;

  • You need to both balance and practice grace and assertiveness

  • You have to work out what your colleagues want and what motivates them

  • You will need to understand that many people desire to feel important and crave to be appreciated

  • The importance of seeing things from the other person’s point of view

  • The importance of talking about your own mistakes before criticising the others

  • The need to make your messages meaningful

  • You need to calm yourself before communicating with others.

I received this excellent advice from Ben Gowland, host of the General Practice podcast, when I first started working with him, and this advice has served me well.

"If its a choice between an email or a phone call,

Phone them.

If its a choice between meeting them or an email,

Meet with them".

Obviously, be respectful of people's time but don't just bombard people with emails. Get to know your team.

I often use WhatsApp voice notes and emojis to encourage a friendlier tone.

Make yourself visible and go the extra mile which may not always be convenient for you.

By purely focussing on implementing the technical and contractual parts of the network, you run the risk of hitting the target and missing the point of the PCN in the first place.

2. Taking time to understand general practice

To support you in building relationships, you will need to get yourself as close to your colleagues as much as possible.

  • This takes time

  • This takes patience

  • This takes resilience

  • This requires you to head into the practice if you do not already

  • This takes leadership and management. And whilst leadership and management are not the same, you are required to do both

  • This means observing the politics and understanding the power dynamics

  • This means appreciating the amount of resource your PCN is receiving and the financial impact this has on your practices

  • It’s about seeing the multiple facets of this enterprise and its complexities

Whilst the PCN is our focus; it's not for your practices.

3. Read the DES and ask questions

To help you better understand the DES, we have:

1. Provided an initial breakdown of the 2022/23 Network Contract Directed Enhanced Service

2. Shared a FREE PowerPoint template to help you communicate the latest updates to your network

3. Created a checklist for your PCN Clinical Leads, who will be leading on specific elements of the DES and other network activities.

4. Shared some top tips for effective management of your PCN Finances

Along with these guides, our friends over at EgpLearning have created some excellent videos on their YouTube Channel, breaking down the DES elements.

Take time to break things down and present them to your network in an easily digestible way. Ask your network and speak to your CD if you are unsure of something. These questions are a fantastic opportunity to build rapport and relationships.

You do not have to be the font of all knowledge.

Check out our resources, but you will need to read the DES yourself. Nonetheless, these resources will give you a flying start if you feel unsure.

Also, remember, your network will be able to pull on their experience or what worked and what could be improved when delivering the DES and elements of the Impact and Investment Fund.

4. Invest in your development

If you are happy to carve out some time to participate in online learning, our PCN Accelerator Programme will be for you.

We cover:

  • An Introduction to PCN Human resources

  • An introduction to PCN Finances

  • An introduction to General Practice

  • Understanding your role and the context you work within

  • Presenting Information and Facilitating Meetings

  • Productivity

  • How to get the most from your PCN Manager and Clinical Director partnership

  • The role of the Clinical Leads

  • Navigating Practices with Confidence

  • Top tips for managing conflict

  • Building your PCN Operating Plan

We also add resources to the platform every month, have monthly drop-in sessions, and you have access for 12 months.

With this support, we can help you accelerate your learning and understanding, which will help your network implement the DES. Click here for more information.

If you are a more experienced manager or you are a Clinical Director, PCN Plus may be for you. Check out the details here.

If you do not need any further support but enjoy our insights, subscribe to our newsletter.

Action step

What three things could start, stop and continue doing today to enhance the relationships with your PCN?

DISCLAIMER: We endeavour to keep our blogs up to date and the information presented reflects our knowledge at the time of publishing

PCN Plus Starting 12th May 2022

A Professional Development Course for PCN Leaders. PCN Plus will help you understand what the role entails, how to make it a success, and how to tackle the many challenges that the part brings.

Facilitated in partnership with Clinical Director Dr Hussain Gandhi and Former NHS Chief Executive Ben Gowland.

If you are a new Clinical Director or an experienced PCN Leader looking for support, click on the image below.

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs, and hosts The Business of Healthcare Podcast.

Find out more about THC Primary Care at

And follow Tara on:

LinkedIn: /tarahumphreythc

Instagram: @tarahumphreyy


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