Primary Care Networks

Legal support for Primary Care Networks

We have extensive experience of working with GP practices and primary care networks (PCNs) to assist in the development of organisational models, internal governance arrangements, employment arrangements, the role of clinical director and arrangements with other providers.

Contact us to discuss how our team of specialists can help.

PCN structures and delivery models

We advise on how best to structure your network, including how to utilise existing GP provider companies and the formation of new companies, for example to employ network staff and create neighbourhood providers.

Network agreement schedules

It is important for the protection of the practices in your PCN to have robust and up-to-date network agreement schedules. The mandatory clauses of the network agreement do not contain detail about exactly how practices will work together to take decisions and deliver network activity or to address the allocation of risk and liability (the default being that all practices are jointly responsible).  NHSE has also added two additional schedules to consider.

We prepare bespoke schedules that ensure your governance arrangements are clear, comply with the requirements of the latest network contract DES specification and advise on neighbourhood provider services when allocating risks and benefits between the PCN practices in the manner you intend.

Collaboration with other providers and multi-disciplinary teams

In Schedule 7, the network agreement s reflect the network contract DES specification which requires PCNs to have arrangements in place for working with other providers in their area, including communication channels and joint decision making and now being neighbourhood providers.

For certain services, such as enhanced health in care homes, PCNs must form multi-disciplinary teams with other service providers. The DES requires that you record arrangements with other providers in your network agreement schedules. The requirements for the new DES can be found in full HERE.

We advise and assist with the preparation of collaboration agreements and advise on appropriate provisions for your network agreement schedules.

Sub-contracting

Many PCNs are sub-contracting clinical and non-clinical tasks to third party organisations. It is essential that these arrangements are carefully documented, comply with the requirements of the DES specification (and practices’ core primary care contracts) and detail the roles and responsibilities of sub-contractors.

We advise and assist PCNs with the preparation of sub-contracts which comply with these requirements.

Employment issues

One of the key issues for PCNs is the employment of additional roles and clinical directors to undertake work on behalf of the PCN practices. You need to consider carefully who will employ these roles and how risk and liability will be shared.

We assist with:

  • Advice on different models for employing network staff
  • Employment and consultant contracts
  • Secondment arrangements
  • Arrangements with third parties employing network staff on behalf of the PCN

Clinical directors

The role of the clinical director is complex and there are many associated issues, particularly the arrangements for engagement or employment of the clinical director, the extent of the role and the clinical director’s autonomy, responsibility for the clinical director’s decisions, actions and omission and conflicts of interest.

We provide training and guidance to clinical directors and PCNs on these complex issues and with preparation of agreements to address them. Read more about our Clinical Director Masterclass here

As Clinical Directors you should have as service agreement setting out what you will be responsible for, and also who will provide you with insurance cover.

Work it out in practice

It is often difficult to understand the reality of the provisions of legal documents. That is why we run interactive workshops in which you find out what really matters, and how you want to do things together. Our Primary Care Advantage programme, led by our leading primary healthcare partners, helps you achieve that, with an outcome which makes sense of PCNs, builds trust between practices, and is legally binding in documents you understand.

Network Contract DES – key dates

The new Network Contract DES contains various key dates of which practices, PCNs and commissioners need to be aware.

Get in touch with our specialist team for a no-obligation chat

This is a challenging time for primary care. Never before has it been more important to have advisors who truly understand the primary care sector and the key issues affecting GP practices.

Our team is based in London, Manchester, Harrogate, Southampton, and Newcastle and we would welcome the opportunity to support you and share our expertise, innovation and know-how in the development of your PCN during this crucial time

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    • Chambers UK 2023
      “Justin was fantastic in supporting us and very knowledgeable.”
    • Chambers UK 2023
      “I was very impressed with the knowledge, level of care and support I received from Ross.”
    • Chambers UK 2023
      “Ross has an amazing knowledge of primary care, both strategically and in terms of what it's like on the ground.”
    • Chambers UK 2023
      “Ross consistently provides a professional and timely service demonstrating real depth of sector knowledge.”
    • Chambers UK 2023
      “He is extremely supportive and very collaborative.”
    • Legal 500 2022
      “Ross Clark. Extremely engaging, knowledgeable and a pleasure to work with. Really respectful and thoroughly decent. He has a good team around him who work very well – from my side he’s developed a good culture and leads a happy and very hard-working team. He has a happy knack of being able to distil and simplify very complex issues within healthcare.’”
    • Legal 500 2022
      “Ross Clark has “deep personal knowledge and expertise” in medical partnerships and dispute work”