It’s all about relationships | What works well between Integrated Care Boards and Primary Care Networks

At THC, we provide resources for Primary Care leaders, and the focus of this week's blog is to highlight what good looks like when it comes to the relationship between Primary Care colleagues based within the integrated care board (ICB) and Primary Care Network (PCN) colleagues.

In this blog, along with a framework to review your initiatives and to understand the lessons learnt, you will find:

✅ 3 examples of good practice from 3 ICBs

✅ 4 top tips to enhance your working relationship

✅ A call to action to help you inform your next steps

DISCLAIMER

I'm sure many of you will read this and think, Tara... This is basic. I know how to do my job and have built great relationships. This blog is not for you.

This blog is for those who are struggling to engage with their ICB or PCN or want a better working relationship with them.

Also included in this blog is a Youtube video talking through

🎯 The video from GPC

🎯 Contract negotiations

🎯 The 1.9% uplift

🎯 Pharmacy First

🎯How PCN roles can better demonstrate their impact

🎯 Integrated neighbourhood teams versus integrated working

Let’s jump in!

It's all about relationships, Integrated Care Boards & Primary Care Networks

At THC, we have a helicopter view and first-hand experience of the different approaches Integrated Care Board (ICB) teams apply to working with their Primary Care Networks.

Teams usually fit within one of the following categories:

Light touch. These teams offer very little visible support and leave networks to themselves.

Supportive. These teams produce newsletters and host engagement sessions. You can call them, and they help you to navigate the system and the challenges you're experiencing.

Dictatorial. These teams dictate what they think networks can and can't do. Information is not transparent, requests for support go unanswered, and sometimes, they control PCN meeting agendas.

However, I do appreciate that the approach may change depending on the nature of the workstream.

In our experience, the teams in Lewisham, which is part of the South East London integrated care system (ICS), Great Yarmouth & Waveney, NHS Norfolk & Waveney, and Kent & Medway fall into the supportive category.

Examples of good practice

My colleague Jade works directly with Dover PCN, which falls within the Kent and Medway ICS of 41 Primary Care Networks.

Here’s what she said:

“Nothing is ever too much trouble.”

“Requests for information are typically sent with a manageable response time, and the finance team has been really helpful with some historical payment issues”.

These may be little things, but they matter.

Jade also feels the PCN managers forum is a productive space and recently attended a webinar which walked networks through how they can achieve the maximum 30% capacity and access payment.

When I spoke with Alistair Lindsay, Associate Director of Primary Care Strategy & Estates, he emphasised that we cannot always meet the demands or requirements of our PCNs.

Engagement is tricky because of the capacity of teams and the number of PCNs in the ICB, but he believes engagement is vital and wants PCNs to see the ICB as an enabler.

The Great Yarmouth & Waveney NHS Norfolk & Waveney team has 4 PCNs and a population of approximately 251,000.

This team includes Amanda Sear, Senior Manager of Primary Care Network Development, and this team has invested time in building relationships with their network clinical directors.

When we recently spoke, Amanda shared that the business intelligence (BI) team has been helping networks to organise and understand their GPAD data to support capacity and access. Emphasising that it’s not a mandate to act on and review the data. It's purely supportive.

I also wanted to shout out to Jasmine Fisher, a Primary Care Network Development Manager also in this team. She’s great!

Ashley O'Shaughnessy, the Associate Director of Primary Care in Lewisham, has demonstrated a proactive approach to supporting their 6 PCNs in establishing the Lewisham Primary Care Leadership Forum, bringing together six PCNs and various stakeholders.

Alongside shaping the strategic direction of this forum, Ashley has successfully secured funding for a designated Chair and administrative support to build momentum.

The ICB team understand and appreciates the time, investment and leadership required to bring together a collective voice.

These examples are not innovative or new approaches to relationship building but highlight the importance of taking the time to

Seek to understand each other's point of view.
Learn from the past to anticipate and mitigate challenges
Review the rules of engagement and break outdated ones
Be visible

These points are further described below.

What works well

1️⃣ Seek to understand each other's point of view.

We see things differently, and that’s OK. It’s important to understand that it doesn’t have to be either/or. It can be AND. Opposing forces and opinions can exist mutually and without conflict.

There’s also a sense that the ICB teams that guide versus dictate are progressing and making a positive impact.

2️⃣ Reviewing the rules

Things are constantly changing. We don’t have control of everything, and unintended consequences happen all the time.

Some rules need to be followed to keep people safe, and there are other rules that are now outdated, present unnecessary challenges and frustrations, and need to be removed.

3️⃣ Learning from the past to anticipate and mitigate challenges

🎯 Think of one successful initiative involving ICB and PCN colleagues, and review what went well and why. The framework below can assist with this.

🎯Now, think of an initiative you felt was unsuccessful. Review this as well using the framework.

Success leaves clues. Take the time to understand what works in your networks, replicate this, and learn the lessons from the past.

4️⃣ Be visible

All teams, no matter where they are in the system, are stretched, and time is precious and in limited supply; however, productive working relationships take time, and the most effective and influential leaders are visible.

And when I use the term leader, I’m talking to YOU. Regardless of your title or perceived position in the hierarchy, when we make ourselves visible and available to the people in our network, our relationships will start to strengthen.

Caution

This doesn’t mean you must attend every meeting or answer every single call and email immediately.

You’ll need to:

✅ Create boundaries and communicate when you are and aren’t available

✅ Regularly assess short and long-priorities

✅ Use technology wisely to aid your communication

✅ Delegate — not everything needs to be performed by you alone

It’s a juggling act, but you can do this.

Finally, it’s worth emphasising that this is a partnership and a relationship that requires effort from both parties.

Call to Action

Is there anything you can do to improve the working relationship with your ICB or PCN?

What's next for PCNs?

It was a pleasure to join Andy Forster, Ben Gowland, and Hussain Gandhi on YouTube to discuss the latest updates happening in general practice and the future of PCNs

We cover:

🎯 The video from GPC

🎯 Contract negotiations

🎯 The 1.9% uplift

🎯 Pharmacy First

🎯How PCN roles can better demonstrate their impact

🎯 Integrated neighbourhood teams versus integrated working

We highly recommend you check it out 😀⬇️

About the Author

Tara and Team THC provide project and network management and training to Primary Care Networks. Between our training programmes, facilitation and interim network programmes, we have now supported over 120 PCNs!

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 250 blogs, and hosts The Business of Healthcare Podcast, where we have released over 290 episodes.