Integrated Care & Social Care

PCN Network: Greater freedom needed to improve local health

NHS Confederation’s PCN Network is calling for increased flexibility in how PCNs operate, with greater support for clinical directors and involvement with system-level work to manage the health of the local population.

More integrated care outside of hospitals is a key ambition of the NHS Long Term Plan.

Primary care networks are already playing a vital role in achieving this goal, but have cautioned that without greater control over the services they deliver and the roles they can employ, they risk being unable to deliver as broad a range of joined-up services, closer to people’s homes and tailored more specifically to their local communities.

Launched back in July 2019 to bring general practices together with other primary care and community organisations in England, PCNs were designed to enable more integrated services for their local communities, which can span between 30,000 and 50,000 people. Currently, there are around 1,250 primary care networks in England.

Currently, the rules on staff PCNs can employ (called the Additional Roles Reimbursement Scheme) have been met with mixed results, easing workload pressures for some, but leaving others feeling restricted in their ability to employ key roles to meet their own local priorities, according to findings from a PCN Network review into how the first year of PCNs has gone across the country.

In its report, Primary care networks: One year on, they highlighted benefits for the health of their local populations in their first year, but that there needs to be a better balance between fulfilling contractual requirements and doing what is best for their patients, as well as more time to develop local relationships.

Ruth Rankine, Director of the PCN Network, which is part of NHS Confederation, said: “The last 12 months have presented a real mix of opportunities and challenges for PCNs. The extent to which they have progressed has been contingent on good leadership capability, a history of strong local relationships and a clear vision of what they want to achieve.

“There has no doubt been obstacles, the greatest one being coronavirus, but in spite of and in some cases, because of these challenges, many have been able to make significant progress.

“In particular, many PCNs have expanded their use of technology, allowing more patients to be seen remotely during the first phase of the pandemic, and to build strong new relationships with other partners across primary care and the wider system.

“Looking forward, there will be new challenges for PCNs, but the pandemic has shown the value of collaboration and integration across health and care and so, there has never been a more important time for PCNs to be part of that transformation. To do this effectively, clinical directors and their managers need more time to engage in strategic decision-making, as well as greater freedom and autonomy to respond to the specific needs of their communities.

“Only then will we retain strong leaders in clinical director roles and get the innovation in primary care that is at the heart of the NHS Long Term Plan and that we have seen a glimpse of in the response to Covid-19.”