Unlocking practice potential in the age of PCNs

In the realm of general practice, a growing predicament looms large. The prevailing system is geared towards the collaboration of practices at the Primary Care Network (PCN) level, which tends to be significantly larger than individual practices. Yet, practices, by and large, resist the idea of becoming PCN-sized entities. The system, undeterred, forges ahead. What implications does this hold for practice mangers?

CREDIT: This is an edited version of an article that originally appeared on Ockham Healthcare

Dr. Steve Taylor recently highlighted a concerning trend on social media. While the global sum for GP practices sits at £104 per person, PCN funding has dwindled to £38 per person. A substantial quarter of the funding funnelled into general practice now arrives via PCNs. The system’s persistent push for PCN-scale collaboration signals a foreseeable increase in the funding routed through PCNs.

With this trajectory in mind, irrespective of the policy’s merits, how should practices strategically respond to this shift?

The allure of individual gain: A common response

A prevalent reaction among practices is a focus on securing the maximum share of funding flowing into the PCN. Practices, in this scenario, exhibit minimal interest in the PCN’s collective efforts or joint initiatives. Instead, they strive to channel resources predominantly to individual practice levels.

However, this approach sparks frustration among PCN Clinical Directors. They find themselves in a perpetual struggle, attempting to balance the PCN’s obligations with fulfilling individual practice requests. The outcome is a palpable disconnect between PCNs and practices, leading to frequent discord.

In the midst of this, a crucial fact often gets overlooked – the primary support for general practice comes from within general practice itself.

Practices supporting practices

The external support network has waned, leaving general practice self-reliant. The system has assumed a distant and preoccupied stance, with the CQC introducing a new practice inspection framework and legislative changes mandating altered work practices. Practices find themselves standing alone.

Ironically, the most accessible form of support exists within the PCN, among fellow practices, and the PCN itself (and local federation, if applicable). The opportunity for mutual learning and support emerges from within this collective.

However, the ‘give everything to the practices’ approach within PCNs misses this chance for mutual support. It accentuates historical divides between practices and reinforces barriers around each practice, despite the shared challenges faced by most.

Optimising resources: A collaborative approach

To maximise the value of funds flowing into general practice, both presently and in the future, practices within the PCN must discern what is best addressed at the individual practice level and what warrants a collective PCN effort. Despite assertions to the contrary, some activities gain value when executed collectively across a group of practices within a PCN. Simultaneously, certain tasks necessitate an individual practice focus. Moreover, there is merit in practices learning from each other’s experiences, supporting one another in implementing optimal systems and processes.

The PCN assumes a pivotal role in facilitating this collaborative approach. Consider the current emphasis on access. The PCN’s responsibility extends beyond crafting a plan for system approval. Instead, it involves determining the optimal balance between PCN and practice provisions, fostering shared learning opportunities among practices to equip them for new requirements.

PCNs can either hinder practices from accessing their share of funding or serve as catalysts for efficiency, innovation, and support. Practices are not competitors but allies. Treating PCNs as a resource competition may jeopardise the well-being of all practices within the PCN. In navigating the evolving landscape of integrated care systems, practices must unite and offer support, and it is the PCN that lays the groundwork for this collaborative synergy.