Primary Care Networks (PCNs)
Primary Care Networks (PCNs)
Primary Care Networks (PCNs) are a key part of the NHS Long Term Plan, with all general practices being required to be in a network by June 2019, and Clinical Commissioning Groups (CCGs) being required to commit recurrent funding to develop and maintain them.
The networks will have expanded neighbourhood teams which will comprise a range of staff such as GPs, pharmacists, district nurses, community geriatricians, dementia workers and Allied Health Professionals such as physiotherapists and podiatrists/chiropodists, joined by social care and the voluntary sector’.
Under the plans, all general practices will be aligned to a PCN, covering 30,000-50,000 patients, with local Enhanced services funded by CCGs and provided through the new network contracts (see below). The networks will provide the structure and funding for services to be developed locally, in response to the needs of the patients they serve. It is important that community pharmacy teams are fully involved in the work of their PCN.
Click on a heading below for more information.
What are Primary Care Networks?
PCNs are based on general practice registered lists, typically serving natural communities of around 30,000 to 50,000 patients. They should be small enough to provide the personal care valued by both patients and healthcare professionals, but large enough to have impact and economies of scale through better collaboration between general practices and others in the local health and social care system, including community pharmacies.
This short NHS England animation explains the concept of PCNs and how this new way of working enables health and other services to work together to provide better access for patients:
The PCN concept is broadly based on the National Association of Primary Care’s Primary Care Home (PCH) model; see below for more information on the PCH model.
The NHS Long Term plan clarified that PCNs will become an essential building block of every Integrated Care System (ICS).
How are PCNs being formed?
A new extension to the GP contract was recently introduced in NHS England’s five-year framework for GP services: the Network Contract (a Directed Enhanced Service) will go live from 1st July 2019 and will enable GP practices to play a leading role in every PCN.
A PCN must appoint a Clinical Director as its named, accountable leader, responsible for delivery, who will also provide strategic and clinical leadership to help support change across primary and community health services.
A PCN cannot exist without its constituent practices, but its membership and purpose should be much wider. The NHS Long Term Plan sets out a clear ambition to deliver ‘triple integration’ of primary and specialist care, physical and mental health services, and health with social care.
All PCNs will have a Network Agreement which sets out its collective rights and obligations as well as how it will partner with non-GP practice stakeholders. It will also include a patient data-sharing requirement, in order to support safe and effective delivery of patient care. PCNs will be the foundation of all ICSs and every ICS will have a critical role in ensuring that PCNs work in an integrated way with other community staff and providers; collaboration arrangements with other local organisations will form a distinct part of every Network Agreement.
Support for PCNs
During 2019, NHS England will establish a new national development programme for PCNs, working with ICS leaders and national bodies including GPC England, RCGP, the National Association of Primary Care and the NHS Confederation Community Network.
This could include:
- Support for development of network leaders, which specifically seeks to build leadership from a broad constituency including GPs (partnered and salaried/sessional), senior nurses and allied health professionals, pharmacists, and managers (practice, Clinical Commissioning Groups and community services);
- External coaching, facilitation, change management, contracting and funding models, service redesign and improvement support delivered direct to networks and through peer network activities across an STP/ICS and/or region;
- Local network development, for example, diagnostic and transformation plan development sessions, rapid improvement cycle implementation;
- Engagement and peer learning events for networks across STPs/ICSs and regions;
- Subject matter expertise, for example, for network-level workforce analysis and redesign, population health, personalised care and patient engagement; or
- Technical support, for example, estates, digital, workforce development.
The Primary Care Home model and the development of PCNs
The National Association of Primary Care (NAPC) launched the Primary Care Home model at their annual conference in October 2015. The PCH model is designed to support the strengthening of primary care in line with the new care models outlined in the NHS Five Year Forward View. The programme was supported by NHS England.
PCH is an innovative approach to strengthening and redesigning primary care. The model brings together a range of health and social care professionals to work together to provide enhanced personalised and preventative care for their local community. Staff come together as a complete care community – drawn from GP practices, pharmacy, community, mental health and acute trusts, social care and the voluntary sector – to focus on local population needs and provide care closer to patients’ homes. PCH shares some of the features of the multispecialty community provider (MCP) care model, but its focus is on a smaller population (30,000 to 50,000 patients) enabling primary care transformation to happen at a fast pace, either on its own or as a foundation for larger models.
NAPC received almost 70 applications to be part of the initial phase of the programme and the successful fifteen rapid test sets were announced on 17th December 2015. In late 2016, additional ‘Community of Practice’ sites joined the programme. Details of these sites and further information on the programme can be found on the NAPC website.
In August 2017, the Nuffield Trust published an evaluation report of the PCH model, which looked at how sites can make early progress with implementing and evaluating their local PCH models and potential challenges.
The following short NAPC video illustrates one example of how community pharmacy is participating in the PCH model:
On 31st March 2017, NHS England published Next steps on the NHS Five Year Forward View, which reviewed the progress made since the launch of the NHS Five Year Forward View (5YFV) in October 2014 and set out a series of ‘practical and realistic steps’ for the NHS to deliver a more joined-up and responsive NHS in England.
One of those steps was to encourage general practices to work together in ‘hubs’ or networks of at least 30,000-50,000 patients – building on the PCH model. In February 2018, Refreshing NHS Plans for 2018-19 set out the ambition for CCGs to actively encourage every general practice to be part of a PCN so that these cover the whole country as far as possible by the end of 2018/19.
Guidance and resources to help community pharmacy get involved in PCNs
The following page contains guidance and resources to support LPCs and community pharmacy teams to get involved in local PCNs.