Preparing your PCN for the future

Robert McCartney, a specialist primary healthcare corporate lawyer at Hempsons, suggests how PCNs should prepare now for the changes in the contracts in 2024.

We are facing a period of uncertainty whilst we wait for a new GP contract to be announced prior to April 2024. It may be tempting to slow down and wait for future announcements but by taking a proactive and positive approach this year you should find that your PCN and your practices will be better positioned when the new contract is announced.

One slightly overlooked lesson from the changes in 2019 was the strength of those areas who had a history of collaborative working and could evolve with the new contract to form rapidly and to maximise the benefits of the PCN concept. This allowed PCN of the Year Awards to be announced within a few months of PCNs being formed.

At that time these areas often had support as part of the NAPC Primary Care Home initiative or the PM Challenge Fund. Now we are in a situation where every practice in the country has had the opportunity to work within a PCN and can take some control over its future, even if it may face rapid evolution in 2024.

The following are some key areas to focus on to ensure your PCN is ready for next year.

  1. Work on your relationships

PCN disputes are becoming increasingly more frequent. There are multiple causes but there is a recurring pattern that issues and concerns have not be addressed early enough. Just like an infection, early diagnosis of problems improves the chance of finding a lasting cure.

Use the time available to address the concerns within your PCN group. Seek support and guidance to facilitate resolution where possible and only in extreme cases restructure your PCN.

Good governance based on openness, transparency, agreed decision-making processes and record keeping are important tools to manage this.

  1. Develop a shared vision

No one will know your community’s needs better than your practices. Use this to build a vision for how health care can work to address these needs. This vision will provide the focus for your practices and will give the blueprint for the interpretation and implementation of future contracts in your area.

Other organisations will find it easier to work with you if they know what it is you are trying to achieve, and this will underpin the transition to integrated neighbourhood team working.

  1. Ensure your infrastructure works

The PCN infrastructure should focus on those elements which provide certainty and operational capability to the delivery of your vision. This includes:

  • Contracts which clearly define the relationships and provide the tools for managing them.
  • Agreements with your staff and workers that are consistent and encourage retention and recruitment.
  • A management and leadership team who can use these resources to maximise the outcomes.
  • Policies and procedures to govern all aspects of the PCN day to day functions

This may include forming a new company or it may include refining your existing relationships. In either case understanding why that option has been chosen and how to use it is important for your members.

Note the requirements in the 2023/4 DES Specification to work with other organisations, identify those with whom a working relationship is important, and reflect how you will achieve this in Schedule 7 of your Network Agreements.

  1. Understand your finances

Another area of dispute relates to not understanding PCN finances and a lack of transparency. Building good financial governance based on budgets and regular reporting will help strengthen relationships whilst will letting everyone know the resources available to deliver your vision.

When the new contract is announced it will be easier to incorporate any financial changes into an established system than to have to create a new one.

By being confident in these areas, and having established relationships, you will be facing the new contract in April 2024 knowing that you are in the best possible position to embrace and react, and take advantage of required changes and opportunities.

First published in GP Business in June 2023.