Are you protected, communicating and networking?
Kirsty Odell, Senior Solicitor in the corporate healthcare team of law firm Hempsons, points the way to develop your Primary Care Network
Published in Practice Management January 2020
All except a handful of GP practices have now come together to form their Primary Care Networks (PCNs). Crunch time is coming for these newly formed collaborations as five of the seven service specifications intended for PCNs will come into play by April 2020.
Is your PCN Agreement fit for purpose for the challenges ahead? You should be asking your PCN: are we protected, communicating and networking?
A big concern for practices joining PCNs is the liability they are opening themselves up to. Most practices are partnerships and are used to the concept of joint and several liability; however, are they prepared to share that liability with other practices that may not operate in the same way? An essential part of the PCN is having robust governance to ensure that appropriate procedures are in place for making decisions, bringing in new members, and allowing or forcing out members as well as dispute resolution. The Network Agreements need to be clear on where liability lies and how it is shared among the practices.
Where a lead practice model is being used, has the lead practice considered its own liabilities, especially with employing PCN staff, and how it will minimise the risks to the partners? Although the lead practice should be contractually indemnified from the other practices, this might prove to be costly, and resource intensive to enforce if a practice is not co-operating.
The emergence of corporate structures for PCNs is increasing – being a structure that offers a way to ringfence liability. This is perhaps easiest (although not exclusive) to PCNs who have a GP Federation already providing services and holding a core NHS contract. The Federation can be structured in a way to provide PCNs limited liability and some autonomy to run the PCN.
Trust is one of the most important factors in collaboration and one that is best built through communication and transparency of information and data. Not only should practices be communicating with each other in the PCN, they should also be communicating with their service users and other health and social care providers. In order to be a successful PCN, you should know by now what you are hoping to achieve and what your main priority areas are in the short term. Agreeing this at the outset will help you to form successful networks.
PCNs must include non-GP members to create the integrated care the Long Term Plan envisages. Have you identified and reached out to other agencies providing, or having an impact on, health and care in the area?
Not all relationships need to be contractual, and many communities are formed by valuable connections made through networking. Looking outward, is your PCN identifying others who offer your patients opportunities to maintain and improve their quality of life? Social prescribers are a vital link for this, and maybe they are making the opportunities for patients to create their networks as well.
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