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What to include in your Primary Care Network underspend proposal

Updated: Nov 29, 2022

This blog is for those of you looking to bid to your local Primary Care team for unspent additional role reimbursement funds from your neighbouring PCNs.

In this blog, we have outlined the sections you might want to include in your underspend proposal, and we cover the importance of:

  • Using positive framing

  • Specifying quantitative data

  • Highlighting risks and intended outcomes

  • Showing that you meet the DES requirements

We have also highlighted 2 podcasts and posed some questions to help you strengthen your future proposals.

Let's jump in!

Proposal Writing Tips

1. Positive Framing

We encourage you to use the term investment versus cost when writing a proposal.

  • A cost to some, may feel like a negative and money that they will not see again.

  • An investment is something you use to increase, enhance, build and improve and this way of thinking helps you to position your proposition positively.

🎯 For more guidance on how to do this, check out our podcast titled - The Framing Effect To Influence Decisions which can be found here

2. Quantitative data and patient outcomes

In your proposal, try to highlight quantitative and qualitative outcomes to help your bid demonstrate how the investment can clearly be measured for the workforce and your patients.

For example, the investment you are asking for could be increasing the number of appointments per week/ month/ per 1000 patients, which could lead to increased patient satisfaction.

🎯 Do you have any hard figures you can present along with qualitative outcomes?

3. Highlight the risks

In your proposal, try to highlight the risks associated with the project to help you improve your project management and to showcase to the commissioner you have rationally thought things through.

🎯 Have you included risk and issues in your proposal?

Sections to include in your proposal

Section 1: Introduction

For example, you could start your proposal with something like this.

This proposal provides the rationale to increase the number of Physician Associates from 2 to 5 fte, providing the opportunity to deliver a robust in-person clinical service to support ABC PCN and address the surge in demand as we approach winter pressures.

The investment totals £160,000, which is in addition to ABC PCN's ARRS budget.

This Investment will

  • Increase clinical capacity

  • Create an additional 10,000 appointments over a 16-week period

  • Increase patient experience as patients will be able to receive an appointment quicker

Section 2: Who in the network will oversee the management of this service?

Include who will be overseeing the project, and include their contact details.

For example

  • Clinical Lead – Dr Beyonce Knowles -

  • PCN Manager – Kelly Rowland -

  • PCN Coordinator – Kim Kardashian -

Section 3: How does the service/provision meet the DES requirements?

To assure the commissioner you are meeting the requirements of the DES, this is your opportunity to highlight this.

Just simply review the DES and copy and paste the requirements.

For example,

To meet the role responsibility requirements - The Physician Associate service will directly:

  1. Provide the first point of contact care for patients presenting with undifferentiated, undiagnosed problems by utilising history-taking, physical examinations and clinical decision-making skills to establish a working diagnosis and management plan in partnership with the patient (and their carers where applicable).

  2. Support the management of patient conditions through offering specialised clinics, following appropriate training, including (but not limited to) family planning, baby checks, COPD, asthma, diabetes, and anticoagulation.

  3. Provide health/disease promotion and prevention advice, alongside analysing and actioning diagnostic test results.

  4. Develop integrated patient-centred care through appropriate wording with the wider primary care multi-disciplinary team and social care networks.

  5. Utilise clinical guidelines and promote evidence-based practice and partake in clinical audits, significant event reviews and other research and analysis tasks.


Section 4: Investment

In this section, this is where you could present the finances.

The investment required to increase the capacity to patients at the desired full complement is £160,000, broken down either daily, weekly, or monthly.

Section 5: Outcomes

In this section, you can present the quantitative and qualitative outcomes you are expecting to achieve.

Section 6: Practice Commitment

I like to include a practice commitment in proposals like this so practices are clear on what is expected of them and are signed up to the proposition.

This commitment may look something like this.

Practices in ABC PCN commit to ensuring there is:

  • A named GP on-site to provide clinical supervision.

  • A named clinical lead to oversee the whole project.

  • A dedicated room for the clinician.

  • Regular meetings to share best practices and allow for reflective practice.

  • A standardised induction that will be followed by all.

  • Flexible movement of roles to support staff absence.

Section 7: How will the provision be sourced?

In this section, present how you will source the provision and the expected timeline for your project to be up and running.

You could start the section with something like this:

ABC PCN has a long and trusted relationship with a third-party service provider, which already provides the network and practices with in-person Physicians Associates. They will be the preferred provider to deliver this service......

Section 8: What are the potential risks associated with the proposal?

Really take the time to think about what could go wrong with your proposal. We call this a pre-mortem. For more guidance on this, check out our podcast titled The Premortem to improve your business results

Some of these risks may include the following:

  • Failure to recruit and retain staff

  • Lack of supervision

  • Lack of space

  • Additional pressure on practices to accommodate more staff

  • The additional pressure on the management team to manage more staff

  • Managing equity of provision and different levels of experience

🎯 What other risks could be captured to strengthen the proposal and what could be done to minimise these?

Section 9 -Your project plan

Finally, you may want to provide a Gantt chart to show the phases of your project

I hope this helps.


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 200 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 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 three 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 massive role in my life.


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