What are Primary Care Networks?
On 1 July 2019, GP practices across England began working with other practices in their local area in groups called Primary Care Networks (PCNs).
PCNs were announced as part of NHS England’s Long Term Plan in January 2019. They have been put in place to improve and extend the range of services that are available in the community and join up the care that is provided from different organisations.
Demand for health and care services is increasing as the population ages. At the heart of our plans to make Primary Care services stronger, general practices are planning and delivering care together in partnership with other health and care services to support their populations by providing high-quality care. It is expected that by practices working together with a range of local providers, including community services, social care and the voluntary sector, they will be able to make resources go further.
In Warrington and we have five PCNs covering the whole patient population. Each PCN is made up of populations between roughly 30,000 to 50,000, although some have slightly more or fewer patients than that. PCNs offer care on a scale which is small enough for patients to get the continuous and personalised care they value, but large enough to be resilient through working in partnership with others in the local health and care system.
Each PCN has agreed their own health priorities based on what local people need. Longer term, we will be able to work together to recruit more staff such as pharmacists and physiotherapists and offer a broader range of services to patients across groups of practices.
By 2023/24, PCNs nationally are expecting to see £1.799 billion come into Primary Care through the national Network Contract Directed Enhanced Service (DES), which is an extension of the core GP contract and must be offered to all practices.
The investment includes funding to support the operation of PCNs and to help fund additional staff, via the Additional Roles Reimbursement Scheme.
Primary Care Networks (PCNs) are expected to bring several benefits to both patients and practices:
Patients will:
- access a wider range of professionals and diagnostics in the community
- access different ways of getting advice and treatment, including digital, telephone-based and physical services, matched to their individual needs
- see an increased focus on prevention and personalised care
- see a wider range of services close to home.
Practice staff will:
- experience a greater resilience by sharing resources, improved efficiency and smoothing out fluctuations in demand and capacity
- see a more sustainable work/life balance: more tasks routed directly to appropriate professionals
- experience more satisfying work: each professional focusing on the tasks they do best
- have greater influence on decisions made elsewhere in the health system
- be able to free up GP time to concentrate on patients with more complex needs
- have the opportunity to work more closely with other practices, especially GPs, having access to larger peer groups of clinicians, supporting their development and building greater resilience
- have access to better data about patient needs and outcomes.
From 2020, PCNs are required to deliver three national service specifications, these will be phased in over the duration of the year.
- Structured medication reviews
- Enhanced health in care homes
- Supporting early cancer diagnosis.
To support the delivery of the national specifications, PCNs will have access to funding to employ additional workforce for their Networks. The Additional Roles Reimbursement Scheme (ARRS) will fund 100% of specific roles coming in over the period of the contract. The intention of the scheme is to grow additional workforce capacity through new roles, and by doing so, help to solve the workforce shortage in general practice.
From April 2020/21, each PCN will be allocated a single combined maximum sum under the scheme. Each PCN’s ARRS Sum will be based upon the PCN’s size of the population.
PCNs will be able to recruit from a designated list of roles as they require to support delivery of the Network Contract DES:
The roles include:
- Clinical pharmacists: Who can make sure patients’ medications are right
- Social prescribing link workers: Who can help address non-clinical issues such as isolation
- Physiotherapists: Who help with recovery and mobility
- Pharmacy technicians: Who help patients get the best out of their medicines
- Physician associates: Who can take medical histories and blood pressures, complete insurance forms and explain treatments, freeing up the GP
- Health and wellbeing coaches: Who work alongside patients who may need additional support
- Care co-ordinators: Who are trained health professionals that help to manage a patient's care
- Dieticians: Who diagnose, treat and educate on dietary and nutritional problems
- Podiatrists: Who diagnose and treat conditions of the feet and lower limb
- Occupational therapists: Who can support with everyday activities which have become difficult
- Nursing Associate and Trainee Nursing Associate: Who can bridge the gap between healthcare assistants and registered nurses
- Advanced Practitioner: Who can offer an Advanced Level of care as a Clinical Pharmacist, First Contact Physiotherapist, Dietitian, Podiatrist, Occupational Therapist or Paramedic
- Community Paramedic: Who can recognise and manage patients with a range of long term conditions, minor illnesses, and injuries. They also have the ability to respond to on the day demand by offering Hear and Treat telephone triage or undertaking home visiting
- Mental health practitioner: Who can provide combined mental health consultation, advice, triage and liaison function, supported by the local community mental health provider
PCNs acknowledge they cannot deliver the outcomes of these specifications in isolation and have therefore started encouraging work with partners in community healthcare, mental health, social care, hospital and voluntary services through ‘Warrington Together’ and the established Provider Alliance Board. This partnership joins health and care across Warrington creating a local Integrated Care Partnership (ICP).
The following organisations are part of the ICP, working together to achieve the NHS Long Term Plan and the Government’s ambition that all parts of England will have joined up systems by 2021:
- Warrington and Halton Teaching Hospitals NHS Foundation Trust
- Warrington Borough Council
- NHS Warrington Clinical Commissioning Group
- Bridgewater Community Healthcare NHS Foundation Trust
- North West Boroughs Healthcare NHS Foundation Trust
- Police and Crime Commissioner for Cheshire
- Primary Care Network Representatives
- Warrington Third Sector Health and Wellbeing Alliance.
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