Primary Care Networks (PCNs)
Three major pieces of work have been published:
- The NHS Long Term Plan
- The GP Partnership Review and
- The GP Contract changes for April 2019 and beyond.
Individually these would have a significant impact on GPs and their practices but taken together they will have the most significant change that we have seen for many years and potentially even greater than the 2004 contract.
The key issue now is that the commitments detailed in these documents are delivered in full, with the minimum of red tape, so they can truly make a difference to those who work at the coal face and we start to address the issues of workload, workforce and financial risk.
Linking into this is the development of Primary Care Networks and the work that practices will need to undertake in the short and long term to make these a success. We recognise there is a huge amount of information available to practices and that it can feel overwhelming, we have therefore created this page so that practices have one place to access all information relating to PCNs.
FutureNHS collaboration platform – PCNs and Practices Support Hub – Intergrated Care
There are a number of documents & guidance available.
- PCN DES Guidance 2023/24
- Investment & Impact Fund 2023/24 Guidance
- Contract Specification 2023/24 – PCN Requirements and Entitlements
- PCN DES – Capacity and Access improvement payment for 2023/24
- Enhanced health in care homes framework
- Ready Reckoner 23/24
- PCN adjusted populations spreadsheet
- PCN DES Standardised GP Appointment Categories (GPAD)
- PCN DES indicators and SNOMED codes
- PCN Subcontract for the provision of services related to the Network Contract Directed Enhanced Service 2023/24
- PCN Workforce – ARRS
- See para 13 for PCN ARRS – 2023/24 pay award: revenue finance and contracting guidance (updated version)
- ARRS Claims Portal FAQs Aug 2023 (FutureNHS login required)
- Patient Group Directions (PGD) use within PCNs
PCN – Network Agreement
The deadlines for PCNs to achieve a number of areas including the Network Agreement have been really short, with advice and guidance coming out piecemeal.
With this in mind and taking into the account the level of queries the office received on this topic, Wessex LMCs organised a number of workshops to support PCNs in developing their agreements. We worked with a number of solicitors and accountants all with specialist knowledge of general practice, to ensure these workshops provided PCNs with basic knowledge of what their agreement may need to look like and areas for consideration. These workshops also offered packages of support from the different solicitors.
Following on from this, the General Practice Defence Fund (GDPF) have released a Network Agreement template with the schedules completed, along with some guidance notes.
- GPDF Guidance on Structuring PCNs
- Guidance Note 1 – Completing the mandatory Network Agreement with its Schedules
- Guidance Note 2 – Employment & Pensions
- Guidance Note 3 – Governance, accountability, liabilities & internal arrangements
- Guidance Note 4 – Contracts, sub-contracts & service delivery
- Guidance Note 5 – VAT & Funding Implications
- Guidance Note 6 – Clinical Director
If you decide for your PCN this is what you wish to use, you will need to review these to ensure they meet the needs of your PCN and we would suggest that you may need to seek legal or financial advice to ensure these are fit for purpose.
If your PCN appears simple with the aspiration in the first year to undertake the requirements of the DES only, then it is likely using the templates will be fine initially. If you are looking at more complex structures or are planning to be more radical, then we would suggest that you need to consider getting specialist advice.
PCNs in year two will continue to grow therefore it is likely that a more robust Network Agreement will be required with the need for specialist advice.
Given there now seems to be wealth of information relating to Network Agreements, we would suggest essentially the options are:
- Read the guidance and write your own schedules
- Read the guidance and use the GPDF template, considering whether specialist advice is needed
- Engage with a solicitor who can provide a template Network Agreement
- Engage with specialist solicitor to write the Network Agreement for you and make them bespoke for your PCN (estimate the cost between £2000 – £2500)