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Why Primary Care Networks (PCNs) Need To Reboot

Tuesday 30th May 2023 - GMT

We’ve come through year end for the Primary Care Networks, and for many of them, this is a time for looking forward.

When they think about 2023/24, some of them will be dealing with reformation where the original set-up didn’t work, and so they’re looking at a new PCN. Some of them will be embedding new members. You can read more about my thoughts on how to run a successful PCN here. And here.

Right now, I’m doing a number of workshops for the PCNs I work with, and a very similar theme tends to come up in all of them – if, when you’re looking ahead, you try to ignore what’s happening now that isn’t working, it will not get better on its own.

Network and practice are the same thing

In these workshops, we have some common exercises to try to help people garner a communal view and get everybody pointed and pulling in the same direction.

Within this, there is something that comes up all the time, and that’s the separation of general practice and PCN. The practices tend to think in terms of practice first, and then the PCN is over in the distance somewhere with someone else looking after it on their behalf.

But network and practice are one and the same thing. They have to be, there’s so much work and money tied up in the PCN that practices cannot afford to just think about themselves, push the network to one side and assume someone else will manage the network on their behalf.

They have to be viewed as one and the same thing fundamentally. The PCN DES, for example, is a contract extension. The only people that can sign up to it are general practices, and therefore that’s what tells you they have to be viewed as one and the same thing.

PCNs encouraged to air their issues

Another thing we go through in the workshops is the types of concerns and problems that have come up over the time the practice has been part of the network. Getting all these issues out on the table gives me a chance to help and support them as I’ve almost certainly got examples of other people that have already been through the same problem.

We look at what motivates them, the challenges they’ve got and the reasons they might have to make a change. If doing nothing isn’t an option – and it usually isn’t – we firmly establish those reasons to give us an anchor point. So if the going gets tough further down the line, we have a reference point for them, we can go back and say, ‘Remember, this is why you want things to change; it’s no longer viable just to sit tight’.

Reaffirming the vision and values

Quite often, I’ll do a piece of work around vision and values to ensure everybody is pointed in the same direction and we actually know what kind of organisational culture they want to have. Part of that is always going to take them into practice engagement. Usually, the complaint there is that the people sat on the network board know everything that’s going on and pretty much no-one else in the practices will have any interest in the network.

That attitude makes things really difficult because, of course, to get the network to deliver means the practices or the network team having to do something. If there’s no engagement, nothing will happen, and the network will fail to progress.

We all want the same thing – a better 2023/24

So there are fundamental issues they need to address. A number of the general practices I work with are looking at restructuring as a limited company to support the primary care network. You can read my blog looking at the pros and cons of this approach here.

Working this way could involve employing an Additional Roles Reimbursement Scheme team to manage the money and the risk, and we’re exploring other potential benefits in the workshops I’m currently running.

Everything is geared around making 2023/24 a successful year and making sure they can deliver exactly what’s required. Most importantly, the networks need to run smoothly. They are drowning in workload, they don’t have enough people to meet the demand, and there’s a desperate need to innovate and work in new and different ways.


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Why Primary Care Networks (PCNs) Need To Reboot

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