Make Q4 Work for Your PCN: Lessons from Past Underspend with Medacy

As always, we write our blog for Primary Care Network leaders, and this one is specifically for those of you who:

• Are looking to make the most of your Q4 budget

• Have had challenges with temporary or inconsistent clinical support

• Want to understand how to turn short-term funding into long-term value for your PCN

As part of our ongoing partnership with Medacy, we recently sat down with their director, Shaun Hockey and asked him all the questions you might be considering when planning your Q4 projects or choosing a workforce partner.

In this blog, we will cover:

• How early planning can turn underspend into sustainable long-term outcomes for your PCN

  
  

• The benefits of consistent, high-quality clinical pharmacy support that improves patient care

  
  

• Lessons from real underspend PCN projects with Medacy

  
  

By the end of this blog post, you’ll have practical insights and actionable strategies to make your Q4 budget work harder, strengthen your workforce, and maximise the impact of your PCN spending.

Approaching the End of the Year

As the financial year draws to a close, PCNs often face the familiar challenge of underspending. For managers and clinical directors, this isn’t just about using budgets; it’s about ensuring your network delivers high-quality care, maximises impact, and supports your teams and patients effectively.

Why Acting Early Matters

When it comes to PCNs' spending, someone recently commented on our social media that PCNs were lazy and poor at planning. We think this is harsh. 

Early planning allows networks to:

• Secure consistent, high-quality staff across clinical roles

• Scope projects effectively to meet objectives such as winter pressures, additional roles, and CPD requirements

• Avoid last-minute decisions that can compromise patient care

Turning a Short-Term Spend into Long-Term Value

Sometimes, bringing in temporary resources or short-term capacity that the network cannot sustain beyond the current financial year can be actively damaging rather than helpful.

The issue isn't just that the capacity disappears when the funding ends. It's the broader impact on team morale, service continuity, and patient expectations. When you bring a service or someone in temporarily, you create workflows around them, patients begin to rely on the service they provide, and the team adjusts to having that extra capacity.

Medacy Case Study: A PCN in Cornwall

One of Medacy’s PCN clients began as a January underspend project. Five years later, the network now employs eight staff through Medacy. Shaun reflects:

“This is a classic example of how you can convert an underspend into something more longstanding.”

Medacy supported a remote PCN in Cornwall serving 67,000 patients to make the most of a short-term ARRS underspend. Eleven pharmacists were deployed over a three-month period, providing targeted clinical support across the network.

Following the success of this initial project, a longer-term partnership was established. Today, the network benefits from six pharmacists and one pharmacy technician, all managed and supervised by Medacy. The team works remotely but is fully integrated with each practice, using EMIS to manage tasks efficiently.

Why This Worked:

• Overcoming Recruitment Barriers: The PCN’s remote location made hiring and retaining experienced pharmacy staff challenging. Medacy’s fully managed model provided a reliable, high-quality clinical team without the HR burden.

• Flexibility and Scalability: The service evolved with the PCN’s changing needs, supporting the network through COVID-19 and seasonal winter pressures.

  
  

• Impact on Care Delivery: GPs were freed to focus on complex care, while patients gained consistent access to experienced clinicians for medication reviews and support.

  
  

• Long-Term Value: What started as a short-term “use-it-or-lose-it” project became a stable, sustainable resource for the PCN.

  
  

This case study shows how Medacy doesn’t just help networks spend their budget effectively, it transforms temporary projects into long-term workforce solutions that strengthen care delivery and improve patient outcomes.

Focus on Quality, Not Convenience

Q4 spending is often reactive, with networks turning to locums for short-term fixes. Shaun notes:

"Some in this space use locums, which is good for speed and flexibility but not so great when it comes to consistency. We employ the team, so we can control it. That’s one of the biggest reasons people come to us."

Consistent staffing ensures:

• Continuity of care across practices

• Measurable improvements in patient outcomes

• Efficient deployment with clearly defined objectives

Practical Steps for Q4 Planning

• Review your budget now – identify potential underspend early rather than leaving decisions to the last minute

• Define time-bound projects – set clear objectives and outcomes for any temporary hires or initiatives

  
  

• Secure consistent, high-quality staff – aim for continuity across practices to maintain relationships and maximise impact

  
  

• Think long-term – Q4 projects can evolve into ongoing partnerships, delivering sustained value beyond the financial year

• Use data to make the case – reporting on spend and outcomes helps demonstrate impact to commissioners and boards

Lessons from Experience

• Well-scoped short-term projects minimise disruption while delivering maximum impact

• Investing in high-impact roles benefits more patients, particularly during winter months

  
  

• Early planning avoids the perception of last-minute reactive spending and positions your PCN as proactive and strategic

Medacy: Trusted Patient-Centred Clinical Pharmacy Services

Medacy provides expert support for PCNs to convert Q4 funding into meaningful outcomes:

• Clinical Pharmacy Services – pharmacists and pharmacy technicians integrated into your network to improve patient care and reduce GP workload

• Additional Roles Reimbursement Support – helping networks make full use of ARRS funding effectively

  
  

• Workforce Planning – ensuring the right staff are in place, at the right time, to deliver measurable outcomes

  
  

Shaun Hockey summarises:

 "The networks that plan ahead get the most from their investment. Medacy can help them do that, securing the right people, for the right time, and delivering measurable outcomes."

Q4 PCN Planning Bottom Line

Q4 planning isn’t just about spending your budget, it’s about decision-making that strengthens your PCN, improves patient care, and builds long-term value. With the right approach, PCNs can act early, make informed choices, and turn potential underspend into sustainable, measurable outcomes.

If you’re starting to plan how to make the most of your Q4 budget and want to explore how expert clinical support could strengthen your network, Medacy can help.

Their team specialises in helping PCNs plan ahead, optimise underspend, and build sustainable workforce solutions that make a real difference to patient care.

👉 Find out more at www.medacy.co.uk or reach out to Shaun Hockey directly at shaun@medacy.co.uk.

Medacy also recently published a blog on winter pressures that you may find useful. You can read that here.

About Us

THC Primary Care is an award-winning healthcare consultancy specialising in Primary Care Network Management and the creator of the Business of Healthcare Podcast. With over 20 years in the industry, we've supported more than 200 PCNs through interim management, training, and consultancy.

Our expertise spans project management and business development across both private and public sectors. Our work has been published in the London Journal of Primary Care, and we've authored over 250 blogs sharing insights about primary care networks.