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Are primary care networks in danger of being a busted flush?


Primary Care Networks (PCNs) were established almost exactly a year ago but have they always been a busted flush?


Pharmacy in Practice would like to know your thoughts.


The initial aims of PCN formation last year was to basically pool resources locally in each area and enjoy a number of local and strategic advantages as a result. There were high hopes for people within PCNs to get together and influence national policy better than individual healthcare professionals or GP practices ould hope to do by themselves. PCNs were supposed to provide vision and keep an eye on the future. I seem to remember quite a bit of synergistic excitement around the NHS five year plan and PCNs at the time.


A recently published report by the NHS Confederation has highlighted some early insights on how PCNs are developing. The consensus among the health professionals who have taken up leadership positions within PCNs is that they require more flexibility and autonomy if the benefits of PCNs are to be fully realised.


The report paints a picture of variability amongst PCNs. One of the key aims of PCNs at the outset last year was to foster collaboration but this report suggests the gains realised on this front have happened in areas where collaborative working was strong before.


There have also been reports of ‘perceived micro-management’ and workload that has turned out to be heavier than expected. The report says that this workload has fallen largely on the Clinical Directors.


Ruth Rankine, Director of the PCN Network, which is part of the NHS Confederation, said:


“The last 12 months have presented a real mix of opportunities and challenges for PCNs. The extent to which they have progressed has been contingent on good leadership capability, a history of strong local relationships and a clear vision of what they want to achieve. There have no doubt been obstacles, the greatest one being coronavirus, but in spite of and in some cases, because of these challenges, many have been able to make significant progress.


“Looking forward, there will be new challenges for PCNs, but the pandemic has shown the value of collaboration and integration across health and care and so, there has never been a more important time for PCNs to be part of that transformation. To do this effectively, clinical directors and their managers need more time to engage in strategic decision-making, as well as greater freedom and autonomy to respond to the specific needs of their communities.


Meanwhile, behind the scenes deep within the smoke and mirrors of the business of healthcare in the UK, PCNs are still the next big thing. The excitement at the prospect of having a shiny new healthcare professional group to access and market medicines to has been palpable all year. And there are agencies, consultancies and representative organisations across the profession, not just pharmacy, who managed to recognise this early, have done very well as a result.


Is the tide turning PCNs? And were they doomed from the start?


Not in pharmacy circles, it would seem. Pharmacy has seemingly taken to PCNs like a duck to water as they say and there have been a few notable pharmacist PCN Clinical Director appointments who have represented pharmacy in a very positive way.


There is no doubt that PCN pharmacists, and more widely pharmacists working in general practice, are on the whole really enjoying the experience. They are finally getting a chance to use the skills, develop new ones, work as part of the multidisciplinary team and also extend their practise and learn new skills.


Sounds exciting, doesn’t it?


GPs don’t seem to universally see it that way.


Many beleaguered GPs have had enough and there is a body of opinion within the GP community that see PCNs as a way of the government reasserting control over their professional network. Much like community pharmacy, many GP colleagues run independent GP practices. These autonomous businesses have for years delivered contracted services for the NHS and it is the view of some that the PCN model may undermine this.


So what do you think?


Pharmacy in Practice will be running a series of articles to mark the first anniversary of PCNs but we need your help so please use the form below to tell us your experiences of working within a PCN be it positive or negative. We welcome pharmacy input here of course but experiences from GP’s, nurses and the wider multidisciplinary team would be most welcome too. With your permission, we will publish your contribution as a letter to the editor.




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