• Tara Humphrey

What is a Primary Care Network? (And how they are evolving)

As always, I write my blogs for new Primary Care Network Managers, administrators and Clinical Directors.

If you are new to your network and still unsure of what it's all about, this blog will introduce you to;

  • What a primary care network is

  • How many PCNs there are in England

  • What services and activities a primary care network typically provides

  • What the leadership and management structure typically looks like

  • The Fuller Stocktake Report and neighbourhood teams

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

What is a primary care network?

In the simplest of terms, a primary care network is a group of general practices and other health and care providers coming together to provide health and care services for their community.

The network has provided the opportunity to introduce new roles to support patient care and the existing general practice team.

These roles are funded via the additional role reimbursement scheme.

Primary care networks typically serve a population ranging from 30,000 to 50,000, but there are some exceptions to this, with networks bigger than 50,000 and smaller than 30,000.

How many primary care networks are there in the UK?

In 2020, NHSE reported;

  • Almost all of the general practices in England have signed up to the primary care network.

  • There are 1,250 primary care networks across England.

What services does a primary care network provide?

At a minimum, a PCN should be delivering on their contractual requirements found in the 2022/23 Network Contract Directed Enhanced Services. Otherwise known as the PCN DES.

  • The vaccination programme – (If your network is still delivering this)

  • Extended Access, which will move into Enhanced Access from 1st October

  • Social Prescribing

  • Enhanced Care in Care Homes

  • Cardiovascular Disease (CVD)

  • Medication reviews and medicines optimisation

  • Early Cancer Diagnosis (ECD)

  • Tackling Neighbourhood Health Inequalities

  • Delivering on the Impact and Investment Fund

  • Monitoring network performance

  • Recruitment and retention activities

  • Stakeholder management

  • The Impact and Investment Fund

At the time of publishing this, many networks will be focussing on redesigning their improved access and extended access into a new service which will be known as Enhanced Access, that should involve consultation with their patients.

The service is to be managed and coordinated at the PCN level.

What income streams does a PCN have?

The core funding streams presented in the 22-23 specifications currently cover the following. (Please see pages 71 and 72 of the DES.) and to calculate your entitlements, please head over to https://www.gprota.net/pcn_calculator_2022.php

a) Clinical Director Payment

b) Core PCN Funding

c) Enhanced Access Payment

d) Care Home Premium

e) PCN Leadership and Management

f) Impact and investment funding

g) Additional Reimbursement Scheme

In the last financial year, PCNs would have also seen;

a) PCN Development funding

b) The CD uplift What does the leadership and management structure typically look like?

How are PCNs Managed?

Whilst the Clinical Director could be classified as the leader; decisions are often made collectively by the general practice partners, practice managers and other senior clinicians representing the practices.

Many networks also have a management function led by a PCN Manager and an administrative team. With many networks managing half a million pounds and more, it's essential that PCNs create an infrastructure to manage their day-to-day business and services.

The infrastructure to support the PCN will typically be managed via the following four models, but there are, of course, some exceptions to this.

  1. A network may have a lead practice model responsible for employment and financial management.

  2. A network may share the employment responsibilities across the network, with each practice employing roles to support the network.

  3. A network may commission a provider like a GP Federation or Community Trust to hold the responsibility for financial management and employment.

  4. A network may create a legal entity to manage the network's business in the form of a Community Interest Company or a Limited Company.

Commissioning a provider or setting up a legal entity reduces the network's financial and human resource risk.

For more information on the various models, please check out some resources from Hilldickson Solicitors.

Many PCNs are not legal entities. They are simply a group of organisations agreeing to work together via a network agreement.

What’s changing?

In June 2021, the highly anticipated Next steps for integrating primary care: Fuller stocktake report was released. To help you approach the document, check out my top tips here.

This is an important document, as it sets the direction for future policy and a vision for integrated primary care. The document has been signed by the 42 Chief Executive designates of the Integrated Care Systems, demonstrating their commitment to enabling change.

From a primary care network point of view, PCNs will be rebranded as Integrated Neighbourhood Teams, where teams from across primary care networks, wider primary care providers, secondary care teams, social care teams, and domiciliary and care staff work together.

For many, this will be a significant change and challenge to increase this level of partnership working. For others, this is already in motion.

Ben Gowland, host of the General Practice Podcast discusses the implications of this change in the podcast below. Click the image to listen.

Please do not forget to read Next steps for integrating primary care: Fuller stocktake report for more information.

We hope this helps.

Please check out:

From coaching to courses. Our blog, newsletters and the Business of healthcare podcast. We are a small team hugely passionate about Primary Care Networks and the PCN Manager role.

We try to give you as much FREE content as we can alongside our day job of managing Primary Care Networks. To date with have written over 200 blogs, recorded 196 podcasts and produce a weekly newsletter.

If you need support to apply the insights we share, we would love to support you.

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.

I have over 20 years of project management and business development experience across the private and public sectors.

I have managed teams across multiple sites and countries, I have an MBA in Leadership and Management in Healthcare, Im published in the London Journal of Primary Care and am the author of over 200 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.