Updated: Aug 13
Primary Care Networks come in all shapes and sizes and operate in a variety of ways. In spite of these differences, there are some commonly shared issues, particularly where individual practices are concerned; they can often feel that;
🌀 They do not understand the purpose of the network
🌀 There is no awareness of who does what at network level, or of what the network priorities are.
🌀 The network demands too much of their time
🌀 The money that comes to the network should go directly to their practice
🌀 They don't agree with how the network is run
🌀 Some practices do more than others which causes friction
🌀 Well-intentioned improvement projects may not be necessary or of benefit for every practice
🌀 More forceful and driven practices may feel under-supported by more passively cultured practices.
🌀 More passively cultured practices can feel intimidated by more forceful or well-established practices.
On top of this, changes in contract delivery requirements and funding requirements may mean that practices are not always aware of the wider NHS infrastructure and why they are being asked to do certain things.
This blog is for practice managers, GPs and other key staff charged with making decisions in their practice, and we explore how practices can help the network to progress and succeed alongside their PCN leadership and management team.
Let’s jump in!
How can practices help the network to progress and succeed alongside their PCN leadership and management team?
1. Acknowledge that there are different challenges, gaps, wants and needs between practices.
It's important to acknowledge that not every practice will be struggling with a particular issue, and well-intentioned improvement projects may not be of benefit to everyone in the network, but the intention behind the activity is usually to either
🌀 Bring money in to the network
🌀 Work more collaboratively
🌀 Take advantage of a perceived opportunity
🌀 Ultimately help the practices
🎯 Practices need to remember that the network is trying to help, and PCN Leaders need to remember that equity is extremely important.
2. Sell the benefits of the network to the practices
Practices need to take a step back and really think about how the network could be better supporting the practices.
As a starting point, Practice Managers and GPs and other key staff charged with making decisions in their practice need to dedicate some time to understanding the benefits of who the PCN brings and to consider how they can work more collaboratively to support each other and reduce the workload.
If the practice isn't sure, they could ask for this to be reviewed in a PCN meeting or schedule a meeting with your CD or manager and then cascade this information to the rest of the practice.
3. Ensure everyone is clear on responsibilities and remit
I think it's really important to understand who is doing what and for each practice to hold them responsible and accountable for the work they say they are going to do.
It's always going to be difficult when practices aren't fully committed, and it causes tensions when it feels like practices are carrying others.
🎯 I think the role of practice in the network is to commit to what they think is fair and to speak up with they can't deliver, or if they fundamentally disagree with the approach.
I think practices also have to acknowledge that there has to be compromise as we can't get what we all want all of the time.
4. Read the information which has been presented
Most networks will regularly have a board meeting, which is accompanied by meeting papers.
We all know how busy things can get, but reading the papers in advance of the meetings is really important. Here is where you find the information you are looking for.
Practices also need to be present at meetings and turn up on time.
This may be an unpopular opinion, but is it a valid complaint to accuse the PCN leadership and management team of not providing the information because practice representatives:
have not taken the time to read it
turned up to the meeting late and then left early
were multi-tasking during the meeting, had their camera off and weren't even listening
This, understandably, makes decision-making extremely difficult.
In a nutshell, it may be helpful for PCNs to be seen as an extension of the practice, with equal levels of input and output on both sides.
Acceptance of some unavoidable truths will also go some way in getting to a place of understanding and shared purpose.
Also, appreciating the following could be helpful.
✅ Everyone works slightly differently, and local priorities may differ, and that’s okay.
✅ Not everyone will get exactly what they want from the network.
✅ In terms of effort; the more you put in, the more you will get out.
✅ There may be lots of additional work in the short-term, but we are all in it together and shared pain just might be a shared gain in the future.
✅ Priorities may change, but the patient should always be at the heart of everything we do.
Here are just a a few practical pieces of advice for you to build on.
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Find out more about THC Primary Care at www.thcprimarycare.co.uk
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About the Author
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 250 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.