What are the opportunities with GP Primary Care Networks?
Since April 2019 all GP practices have been strongly encouraged to form Primary Care Networks (PCNs) covering a population of 30,000 – 50,000 people. Almost every practice has joined a PCN, with some PCNs being just one very large practice, and others being 15 or more small practices. Each PCN covers a co-terminus geographical area. PCNs have a network agreement which all the practices sign up to as the “Core Members”. There is a mandatary agreement prescribed by regulation, and then seven schedules in which most of the detail is put in by the PCN to suit their particular way of working. As PCNs take on more services, so the governance surrounding them is becoming more sophisticated, and the PCN agreements reflect this.
Each PCN has a “Clinical Director”, who must be a GP. They have certain obligations, and to some extent are the accountable officer, the chief executive and leader of the PCN rolled into one. Potentially it is a daunting task, with only a day funded to carry out their duties, much of the time is attending meetings with the Clinical Commissioning Group to find out what PCNs must do, may do, are funded for, and how they fit in to the healthcare landscape. PCNs are often described as the building blocks for health and social care.
Initially PCNs were funded to provide two services – Clinical Pharmacists whose main task was to review the medication of patients, and social prescribers, to enable patients to access other services to assist their health and wellbeing. Social Prescribing is the one role where it is anticipated that the PCN will subcontract with another organisation to provide the service, and therefore an administrative cost is also funded in addition to the actual cost of employing the social prescriber. A number of charities have stepped in and offered to train and supply people to carry out the role. These people are link workers who help the patient to view their health and social care needs in a more holistic way, and identify what is important to them. Based on this, they will then introduce them to statutory bodies, and also other community groups who are able to help them. It is important that the community groups, often run by charities, ensure that the link workers know that they exist, and what they do, so that people are referred to them.
GPs also need to be reminded that they have available social prescribing for people with long term conditions, mental health issues, with complex social needs, or who may be lonely and feel isolated. The expectation is that there will be 90,000 people being referred to social prescribing in two years’ time.
If your charity offers a service to which people could be referred, then find out from a GP practice in your area who the social prescriber link worker is, and start building a relationship with them. Be explicit about what you offer, and what you do not offer, and your ability to take people with different conditions. Some patients may be very challenging and require a degree of expertise. You may specify that they must be accompanied by a carer. Make your referral process as simple as possible, so that the link worker can easily refer a patient to you, and the patient is able to find you. At best you will be at the surgery at specified times. Make sure you are able to show your successes with case studies and if you have hard measured data to back you up, that will be a great advantage.
Most important is the feedback that is received by the PCN from the patients referred to you, and at best you are able to show that the visits to the GP, and other health and social care services, have reduced as a result of your service.