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What to focus on in Q4 | A guide for Primary Care Network Leaders

Updated: May 1

At THC Primary Care, we provide resources for primary care leaders, and we try to give you as much FREE content as we can alongside our day job of managing Primary Care Networks.

Four times a year, we provide a summary of the PCN DES - and a suggested action plan of where to focus your attention each quarter.

In this blog, you will find:

1️⃣ A video overview of what to focus on in Q4

2️⃣ An overview of the PCN Finances for 23/24

3️⃣ A reminder of the PCN national service requirements

4️⃣ A checklist to guide your network through your Q4

5️⃣ A link to a video which walks you through how to create your PCN dashboard ( If you do not have this already)

To support this blog, you may need access to the following documents.


The information presented in this blog is just a guide for you to edit, amend or disregard as you see fit.

Let's jump in!

what to focus on in Q4 - a guide for primary care network leaders

Section 1: Your Primary Care Network Q4 Overview

Section 2: Primary Care Network National Payments for 23/24

Each network is set to receive the following (these are set payments):

Payment provisions and calculation 23 / 24

  1. Clinical Director Payment

The Clinical Director payment for the period 1 April 2023 to 31 March 2024 is £0.72963 per registered patient per annum

2. Core PCN Funding

Core PCN funding for the period 1 April 2023 to 31 March 2024 is calculated as £1.50 multiplied by the PCN registered list size.

3. Enhanced Access Payment

The Enhanced Access payment for the period 1 April 2023 to 31 March 2024 is calculated as £7.578 multiplied by the PCN’s Adjusted Population.

4. Care Home Premium

This payment is calculated on the basis of £120 per bed for the period 1 April 2023 to 31 March 2024.

5. PCN Leadership and Management Payment

The PCN Leadership and Management payment for the period 1 April 2023 to 31 March 2024 is calculated as £0.684 multiplied by the PCN's adjusted population.

6. Capacity and Access Support Payment (70%)

The Capacity and Access support payment for the period 1 April 2023 to 31 March 2024 is calculated as £2.765 multiplied by the PCN’s adjusted population.

7. The Local Capacity and Access Improvement (30%)

This year, the Local Capacity and Access Improvement payment is a payment of £1.19 pp made in respect of documented improvements in the following key areas:

  • Patient experience of contact

  • Ease of access and demand management

  • Accuracy of recording in appointment books

PCNs must have worked with the commissioner to assess and record the PCN's position at the start of the 2023/24 financial year in relation to the three key areas, as set out above.

8. The Investment and Impact Fund

As stated in the GP update letter, the number of indicators in the IIF was reduced from thirty-six to five at £0.95 pp with a focus on the following:

  • Flu vaccinations x 2 indicators

  • Learning disability health checks

  • Early cancer diagnosis

  • A two-week access indicator

  • It is also worth noting, the IIF indicators are not mandatory, and networks can choose not to pursue these.

9. The additional roles reimbursement scheme

£22.67 pp

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Section 3: Primary Care Network National Service Requirements for 23/23

The national PCN services include:

1️⃣ Extended Hours Access and Enhanced Access

2️⃣ Medication Review and Medicines Optimisation

3️⃣ Enhanced Health in Care Homes

5️⃣ Social Prescribing Service

7️⃣ Tackling Neighbourhood Health Inequalities. Check out our introduction to health inequalities here. The NHSE 23/24 guidance can be found here.

1️⃣ 0️⃣ NHS England also introduced two new Quality Improvement modules in 2023/24, which are to be discussed in two PCN peer-reviewed meetings.

Networks may also have other local (and PCN-based services and projects) they are delivering.

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Section 4: The Primary Care Network Q4 checklist

To support you over the next 90 days, please feel free to amend and follow the Q4 checklist below.

Schedule a Q4 finance meeting in January to review ⬇️

Status/ Outcome

  1. Income

  2. Expenditure

  3. Investment and Impact Fund performance

  4. Outstanding invoices

  5. Money owed

  6. Spend against the Additional Roles Reimbursement Scheme  

  7. Is the financial governance clear?

  8. Do we have access to CQRS to ratify any payments?

  9. What other information do we need?

  10. Who needs to be involved in these conversations?

Services and contractual requirements

Questions to consider

  1. Is there an accurate monitoring system in place?

  2. Are all practices delivering to the same standard?

  3. If a board member asked us tomorrow to provide evidence of how the PCN is progressing against the DES and local contracts, how quickly could you obtain this information?

  4. Is there anything we can do to enhance performance in Q4?

  5. Who needs to be involved in these conversations?


  1. What projects are the network delivering?

  2. How are these projects being monitored?

  3. How close to completion are they?

  4. Did any projects fail before completion?

  5. Is each project being evaluated?

  6. Who needs to be involved in these conversations?

Risks and issues

  1. What ongoing risks and issues is the network experiencing?

  2. What is being done to address/ mitigate these?

  3. What is the implication of doing nothing to address the risks and issues in the network?

  4. Who needs to be involved in these conversations?

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Presenting your quarterly dashboard / annual review

One of the most common complaints network staff share with us is the lack of communication and visibility regarding progress.

The board wants to know what is happening behind the scenes (particularly where progress is and isn’t being made), so I walk you through a simple way to present this information in the video below.

We hope this helps!


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About the Author

Tara Humphrey

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 280 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 120 PCNs by providing interim management, training and consultancy.

I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.

I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.


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