Quality Improvement – Webinar summary

The BMA’s ongoing Learning and Development team held two webinars that covered the vital areas of quality improvement for PCNs and the journey of a clinical director.

Quality improvement

We began by defining Quality improvement (QI) and discussing its importance in general practice. We talked about system enablers and what can be done at the PCN level. We also learnt about internal and external factors that impact and encourage the right culture for QI to be successful.

Although there are many commonly used tools, we know that many are based on the Plan Do Study Act (PDSA) cycle (see slide below). We did, however, cover, an additional tool that can be used for both small and large QI projects; Process mapping. This activity will help the project team to identify the problems that exist within complex pathways. This should be a team exercise and ideally should involve your patients too. Dr Sian Howell, from Healthy London Partnership, talked about how to start mapping using the example of repeat prescribing.

  1. Decide an area to improve e.g. Repeat prescribing
  2. Put one colour post-it note onto a board per each identified step in the process from start (patients requests a medication) to finish (patients receives medication)
  3. Use another colour post-it note to identify problem points, or waste points in this process for e.g. the use of faxes
  4. You may then want to seek out other data to supplement this ‘diagnostic’ e.g. your typical repeat prescription duration compared to other practices and networks

This creates a shared clarity of your current process and can identify a helpful area to change. If done thoroughly, the exercise helps narrow your focus and enrolls the team in your program of change.

The journey of a clinical director

Our fifth webinar looked at sharing experiences and best practices for clinical directors. BMA trainer Susan Edwards was joined by Sarit Ghosh – Clinical Director at Enfield Unity PCN – one of the largest PCNs in the country with 160,000 patients.

Sarit talked about his journey as a Clinical Director and shared his tips and thoughts on how to set up a governance structure. He also talked about the challenges of creating a super-partnership, and how he found the recruitment process for the additional roles.

Attendees also learned what a typical working week looks like for a Clinical Director and how to fit everything in.

Delegates could also find out what was really important to get right and why and what Clinical Directors should focus on in terms of their professional development.

There is still time to book a place on the Learning and Development course, please sign up here.

Chloe EmmersonQuality Improvement – Webinar summary
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Takeaways from the 2020 primary care networks conference

Missed the conference this year, or looking for a recap? Read on for a whistle-stop tour of some of the highlights and discussion topics of the day.

On February 8, the BMA (British Medical Association) held its second PCNs (primary care networks) conference, in central Birmingham. Just two days before the conference, the BMA GPs committee England announced it had voted to accept a package of changes to the GP contract for 2020/21. The conference was the ideal opportunity for delegates to discuss the deal and share their views on what the decision meant for them.

There was a real sense of community on the day, with over 350 clinical directors and medical professionals attending. The agenda was packed with presentations and sessions; partnership working, services, finance, LMCs, and workforce considerations. With several breaks and a catered lunch, there was ample opportunity for delegates to network and share experiences.

Introductions

Sessions were aimed at giving insights, practical suggestions and shared best practice. But first, the day began with Krishna Kasaraneni welcoming delegates to the second PCN conference the BMA has held after a successful event in 2019.

The next presentation was by Ed Waller, director at NHS England, and was highly anticipated. With an earlier deal having been rejected by the GPs committee three weeks ago, there was relief that following months of negotiations between the BMA, and NHS England & NHS Improvement, an agreement had been reached. The new deal builds on last year’s five-year deal; two highlights are additional funding for increasing and diversifying the workforce and a paring back of service expectations.

Mr Waller’s presentation also covered PCN stability, the new ‘investment and impact’ fund, the Government’s manifesto pledges, vaccination incentives, improvements to maternity care and GP working conditions.

Managing workloads

Given that a recent BMA survey found that 49 percent of clinical directors viewed their workload as unmanageable, the topic of service specifications was also key. Indeed, Mr Waller thanked delegates for ‘telling them [NHS England] what they thought’ of the original agreement, raising a laugh from the audience. The new contract, he said, showed that ‘the views of general practice were listened and responded to’. The agreement includes a simplification of the three services introduced in 2020/21 and two further services will be deferred until 2021/22, reducing the impacts and expectations on PCNs. (Read the full GP contract agreement).

The Additional Role Reimbursement scheme was another area of change. For 2020/21 the Government will provide 100 percent reimbursement for the roles that fall under the scheme. Further, there are now 10 roles included – physiotherapists, physician assistants, pharmacy technicians, and others.

PCNs now have an opportunity to provide the additional services and care to patients that have been sorely needed, and to create workforces that reflect their individual population needs. The questions asked after Mr Waller’s presentation predominantly focused on these two areas of change, and the theme continued in conversations throughout the day. In particular, the Workforce session gave a practical insight into the range of roles.

Call for investment in infrastructure

Next was a presentation by BMA GPs committee chair Richard Vautrey. He was enthusiastic about the benefits that the funding changes, pared-back service expectations, and additional roles would bring but highlighted that with these steps forward, other areas risk falling behind. For example, the logistics of accommodating increased workforces will need to be addressed. He called upon the Government to invest in capital expenditure to ensure all practice premises are fit for purpose.

This, he said, connects to the importance of building care across communities. By investing in capital expenditure, the benefits would include reducing duplication of effort and minimising waste. BMA lobbying to increase investment in healthcare infrastructure will continue. Dr Vautrey shared his views on the GP contract agreement in an earlier BMA blog post.

Additional roles

After a chance to refuel with coffee, the sessions began. The Workforce session had multiple speakers, representing roles included in the Additional Role Reimbursement Scheme. Social prescribers, physician associates, primary care paramedics, clinical pharmacists and first contact practitioners all gave overviews of their roles, accountabilities, and ways they supported PCNs – and emphasised the benefits each role offered PCNs.

Delegates were curious to learn about the everyday activities of the roles, and the practicalities, successes, and challenges of integrating new roles into a PCN – particularly when they’re not well-known to patients. The speakers gave examples of how their roles had supported the wider practice teams, freed up GPs’ time and provided services tailored to specific cases.

To diversify and grow a practice workforce, we need time – giving time to the new roles to build trusted working relationships, particularly if staff are new to the role, recently qualified or split across multiple sites. The speakers were clear, however, that with open discussions and considerate planning, these challenges can be overcome.

Tax matters

A lunch break gave plenty of time to network (or get some fresh air in blustery Birmingham) before the event turned to cover finance.

The feedback and questions from delegates on this issue were taken on board and were of considerable use to the BMA’s GP committee, NHS England and HMRC. The latter’s representative said he would ‘take this back and raise it as a high priority’ with the hope of getting information about tax to clinical directors in the coming weeks. After a meeting with the BMA, HMRC also agreed in principle to the BMA’s offer to draw up a series of models in which PCNs operate so VAT advice can be offered in the future. We’ll share further information once we have it.

Practical advice for success

In the final session, Neil Parsons spoke about the award-winning PCN for East Cornwall. This was an opportunity for delegates to get a practical example of methods to create a successful PCN. Made up of nine practices in rural locations and serving a population of 105,000, including a high proportion of elderly patients, Mr Parsons noted the willingness between practices to collaborate. As he put it: ‘All nine practices are islands but under the waterline, the land is connected.’

East Cornwall identified several areas that needed to develop as the PCN took shape, including digital infrastructure and services, strong communication and trust with the local commission, workforce investment, leadership development, and partnership working.

It was known early that to ensure cohesion and efficiency between practices, improvements to their digital infrastructure were essential. As a larger group there was more opportunity to negotiate and fund newer technologies, e.g. procuring online consultation software consultations, which has eased some of the pressure on GPs by enabling video links – particularly helpful in rural locations.

Another area identified for development, and a perfect example of the benefits of the new Additional Role Reimbursement scheme was the changing workforce. For example, East Cornwall hired an onsite pharmacist to work across the nine practices, something individual practices were unable to afford.

One of the concerns raised during the day was the financial stability of PCNs. Mr Parsons touched on this during his presentation, noting that one of the key aspects of his PCN’s success was in the time and effort given to building a trusting and communicative relationship with the commissioner, as well as between colleagues across the practices.

To mitigate financial risks, the team also set up a limited company, Kernow Health East. This sets it apart as a legal entity and enables the workforce to be retained for the PCN rather than individual practices. Although this incurred costs, it is a way to ensure stability and legal clarity.

This was an insightful session which shared the challenges faced by practices joining forces, and practical methods to overcome them. Many other delegates agreed with Aileen Tincello, who expressed what others had said throughout the day: ‘It’s really inspiring to hear practical ideas that I can take back to use in my PCN.’

The conference aimed to bring clinical directors and healthcare professionals together, in a sense of unity, best practice, and development. But don’t just take our word for it; GP Kamilla Kamaruddin said: ‘[The conference was] really helpful to network, share best practices and even share the unknowns,’ and GP Bert Jindal said: ‘[The conference has been] good for networking, setting standards, and useful for calibration.’

Chloe EmmersonTakeaways from the 2020 primary care networks conference
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GP contract agreement struck

The BMA’s GP England (GPCE) committee has voted to accept a package of changes to the GP contract for 2020-21, which includes funding to attract more doctors to take up partnership roles and expand the practice team seeing patients in surgeries.

The agreement, which builds on the five-year deal announced last year, is the result of months of negotiations between the BMA, NHS England and NHS Improvement and comes three weeks after GPCE rejected an earlier deal.

Draft service specifications for Primary Care Networks (PCNs) – outlining the responsibilities of these groups of practices and community providers in the coming years – have been significantly pared back after widespread criticism from the profession that draft versions published by NHS England and NHS Improvement at the end of last year were unfair, unrealistic and burdened already struggling-practices with unsustainable workloads.

You can read more detail on the deal here. 

The BMA’s PCN 2020 conference in Birmingham on Saturday 8 February will be an opportunity for attendees to hear about the agreed package in more detail from BMA representatives and NHS England on how this will impact and shape the future of PCNs. Attendees can also share best practices, network with peers and access practical support from experts in VAT, HR, legal issues and insurance.

For more information on the event go here. 

 

Chloe EmmersonGP contract agreement struck
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What are the insurance implications of Primary Care Networks?

Since Primary Care Networks (PCNs) have been introduced, there has been some speculation about what insurance cover is required.

A GP surgery under a PCN has new and additional responsibilities they’re unlikely to have had before. This has implications for the following insurance risks;

  • Medical Indemnity
  • Directors & Officers liability
  • Employers and public liability

How your structure affects your insurance

Exactly what your PCN need will be somewhat dictated by the structure of your PCN; a flat practice set up, for example, might involve the sharing or standardisation of employment contracts. This could impact on the employers’ liability insurance for each individual surgery.

Employer’s liability is a legal requirement in the UK so if you have set up your PCN as a Ltd company in it is own right, you will need to have Employers Liability under the legal name of that Ltd company.

If you have a flat practice structure, we advise that you inform your insurers of your PCN activity. If you have a lead practice, you may only need to extend the liability cover on the surgery insurance for that lead practice.

As an employer, you’re effectively extending the place of work to your workforce.

Impacts made by decision makers

Whatever structure you have, your PCN will have appointed a clinical director. Clinical directors will have started to and will continue to take on a growing number of strategic decision making responsibilities as a PCN grows. You may also involve practice managers to work together with clinical directors on PCN related activity.

As these responsibilities will be relatively new to these decision makers, it is important to note the potential liability risks. With responsibility comes accountability. A management liability insurance policy offers protection in the event of a director or officer being accused of wrongdoing. This can mean a variety of things including but not limited to the following;

  • Breach of contract with a supplier
  • Breach of regulation
  • Breach of trust with a patient
  • Unfair dismissal of employees

Management liability insurance is designed to cover the legal costs of defending a claim of this nature and also providing compensation if required. If a clinical director or decision maker within the PCN was found to be liable of wrongdoing, their employer (whether that is the practice or a PCN set up as a limited company) would need to cover the legal and compensation costs themselves.

Want to know more?

As the BMA’s appointed provider of insurance services, we’re able to advise members about their insurance requirements for PCNs.

You can find out more about the services we offer or watch our webinar on the topic on our website.

Chloe EmmersonWhat are the insurance implications of Primary Care Networks?
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Managing change – webinar summary

Last week the BMA held its second webinar as part of its package of learning and development support aimed at honing your skills as a primary care network lead.

This webinar focused on Managing change and is one of a suite of digital and face to face events taking place between now and April. They are led by the BMA’s team of expert trainers and are designed to help you effectively manage and lead your teams.

The webinar covered these key topics:

  • Understanding how people experience change and what you can do to support them.
  • Dealing with difficult reactions, understanding fears and redirecting difficult behaviour.
  • How to communicate effectively at the different stages of change. Creating the climate for change, supporting and engaging throughout and finally sustaining the change.

Another key area that was considered was the difference between change and transition – a subtle one but crucial in order to ensure successful outcomes for organisations.

The best way to think about the difference is to see change as the way things will be different, whilst transition is how you move people throughout the stages of change to make it work. The visuals below explain more about the three phases of transition and explore in more detail the difference between change and transition.

The Three Phases of Transition Change vs Transition

The next webinar as part of the series this Wednesday is on 22 January and will cover using data to improve population health.

For more information on the Learning and Development package please click here.

Chloe EmmersonManaging change – webinar summary
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PCN service specification and GP contract update

The BMA has voted against a contract agreement with NHS England for a GP contract following criticism of the service specifications for PCNs outlining what is expected of Primary Care Networks (PCN)s over the next four years.

Members of the committee, who met on Thursday 16 January, were presented with a package of changes but voted against accepting them. GPC England will now return to negotiations with NHS England.

Details of the package remain confidential.

A separate motion at the GPC committee condemned the original draft service specifications, put forward by NHS England and NHS Improvement in December, and called for a Special Conference of English LMCs (Local Medical Committees) to allow GP representatives from across the country to debate and consider the outcome of contract negotiations.

Since the specifications were released for consultation at the end of December, the feedback from GPs, PCNs, LMCs, and many local and national organisations was overwhelmingly negative, with practices concerned at the levels of workload involved, especially for those networks that were struggling to recruit additional staff.

GPs said the initial service specifications were ‘too rigid’ and were ‘overloaded’ and called for NHS England to provide more targets for areas such as social prescribing, IT and personalised health budgets. See article here. A BMA survey of clinical directors released this week found that whilst PCNs could make a positive difference with the right resources time and practical support they were being hampered by workload constraints.

BMA GP committee England chair Dr Richard Vautrey said:

The message from GPs in recent weeks has been a clear one: proposals put forward by NHS England and NHS Improvement before Christmas have clearly been judged by the profession as unreasonable, and completely unachievable.

“At a time when demand and workload for practices are unprecedented, GPs working on the front line felt these draft specifications piled on more pressure and would undermine primary care networks that were only just getting off the ground.

“This overload would therefore put in jeopardy all of the good work and progress PCNs have already made for the good of both staff and patients.

 “This is therefore not the end of the process, we have a clear mandate from our colleagues, to negotiate a deal that truly benefits and safeguards general practice, family doctors and their patients.”

For the full BMA statement go here.

Chloe EmmersonPCN service specification and GP contract update
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What’s next for your primary care network?

Now that you have formed your primary care network, it is time to shape and direct your local vision in a way that truly improves the lives of both your patients and staff.

The BMA is offering a bespoke learning and development package. This is designed to provide PCN leaders a space to share experiences and establish a network of support. In so doing, everyone will benefit and gain from the experience, learning and innovation of their peers.

Given our national remit, we are ideally placed to bring leaders together to maximise your chances of success in these new roles. Through this opportunity the BMA will support you to ensure general practice can meet the future needs your community.

The BMA has been at the forefront of the PCN developments from the very beginning, negotiating the contract, and building a new direction for the profession. The next phase of our development was to work with clinical directors and leaders in the field to create a programme of learning and development tailored to meet your needs as you embark on this journey. The programme will ensure we all learn from what has gone before, share best practice and lessons learnt to help achieve the ambitions of PCNs by allowing you to flourish in your lead role. We will achieve this by bringing together experts and clinical leaders to show how innovation and new ways of working can help your PCN.

We are offering masterclasses that will give access to both clinical and non-clinical experts to look at strategic planning, workforce planning, and leadership and management. Wrapped around the masterclasses will be a series of webinars and e-learning modules offering crucial insights and opportunities to engage, question and find ways forward that work for you and your PCN.

This bespoke package will be as reactive as it is informative, with your needs at its core. The programme runs from January 2020 to April 2020 and over four months we will provide a framework to your learning so you can plan and manage your workload. Each topic is designed to tackle the current issues and will build on your professional development so that you can set yourself up for success in your respective leadership roles.

The masterclasses are made up of 4 sections taking place across 2 full days and have been designed to enable peer group interaction and learning. The last session will be personalised and offer 1-2-1 career coaching clinics and additional seminars that respond to emerging issues and themes.

There will also be opportunity to learn about new developments across the country to aid innovation in your practice and provide an opportunity to share best practice with others. These masterclasses will be available in Bristol, Leeds and London. The will extend the webinar and e-learning support that is part of our offer. Responding to your needs, we will also provide the opportunity for a virtual conversation on a hot topic relating to issues emerging from the masterclasses. These online hot topic conversations will allow you to address issues you are exploring in the moment.

As we head into the busy winter months there could be no greater reminder that now is the time to innovate and develop general practice – to bring together the best ideas and learnings from around the country and build a more sustainable profession which can deliver better care in an increasingly different environment. Our bespoke package will give PCN leaders the best opportunity to respond to these changes.

Maeve Regan is Learning and Development Product Manager at the BMA

Learn more about how we can support your PCN

Book your place on our PCN conference in Birmingham, February 8 2020

Sian HeaphyWhat’s next for your primary care network?
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The explainer: What are primary care networks?

Primary care networks are being set up to promote integrated care. What will it mean for GPs?

What are they?

PCNs are groups of GP practices working collaboratively in a formalised structure, typically covering a population of 30,000 to 50,000 patients, and combining with other primary and community services and local organisations to ensure an integrated approach to health and care for that population. It is expected that all areas in England will be covered by one by July.

Why are they being established?

The intention behind establishing PCNs is to focus services around local communities, building on local GP practices to help rebuild and reconnect primary healthcare teams across the areas they cover through the network.

The BMA GPs committee negotiated a new directed enhanced service with funding entitlements in this year’s contract to fund PCNs because the ownership for leading local services should sit with GP practices. Only GP practices can set them up. It is hoped they will alleviate workload pressures and allow GPs to concentrate more on the most complex patients.

Aren’t there already networks?

Yes. In fact, most practices in England work in some kind of network. The difference is PCNs have the support and backing of a national contract and formalise the establishment of networks in a consistent way.

Will they offer new services to patients?

Yes. From 2020 there will be the potential for additional funding of new services in line with the aims set out in the NHS Long Term Plan. These include medications review, supporting early cancer diagnosis and cardiovascular disease prevention and diagnosis.

What kind of funding will be available?

There will be payments to practices for engaging with PCNs, and other payments direct to the network as entitlements; some are ringfenced (eg for a clinical lead and a contribution towards new staff costs) while other payments are for networks to decide the use.

How much flexibility will be permitted on the size?

The thinking is that the practitioners involved will still have a reasonable chance of knowing the people they are working with, but that PCNs are large enough to have an effect and make economies of scale. However, if practices think they have a good case for forming a larger or smaller network, they should make it to their CCGs (clinical commissioning groups).

Could a large practice be a network in itself?

Yes, particularly those practices which have 30,000 to 50,000 patients and cover multiple sites within a geographical area.

What happens now?

Practices are being urged to talk to their neighbours about forming a network. Local medical committees are in an ideal position to coordinate and mediate where necessary and the BMA will provide advice and guidance. The new PCNs will submit registration information to their CCGs by the middle of May, with CCGs confirming the network coverage by the end of May. They are planned to go live in July.

Find out more

Sian HeaphyThe explainer: What are primary care networks?
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The one-stop shop for primary care networks

The publication of the PCN agreement is only a couple of weeks away and colleagues across the country have been sharing their thoughts with us about the challenges and opportunities that PCNs bring to general practice and GPs.  There are still many unanswered questions for colleagues and with any change it is inevitable that there will be concerns about how these changes will impact you personally and where you can get the support you need.

So, here it is – Today, the BMA has launched the support package for setting up PCNs, starting with The primary care handbook, which offers guidance, considerations and options for all PCNs and practices in the country.  The handbook includes detailed guidance on:

  • Governance structures
  • Internal governance and decision making
  • Potential PCN structures and employment options
  • PCN funding
  • PCN future workforce options

This handbook will help you get ready for the roll out of PCNs on 1 July this year.  But this is not the only support the BMA is going to provide for you. Over the coming weeks, we will release a suite of BMA resources, which will provide you with tools, training and support to guide you through the process of setting up a PCN. From July onward, we will be launching a BMA PCN membership offer, providing ongoing support that is tailored for your PCN.

This is a professional package built by the team that negotiated your contract and knows it best. It will include all the support that you need not just for today, but for tomorrow and beyond.

The next step is to read the Primary Care Network Handbook. It may look daunting, but offers everything you need to know before making any decisions on how your PCN is going to shape up.  Get in touch with your LMC to discuss the local challenges that you face. For specialist advice on aspects of how to structure your PCN, get in touch with the BMA.  While the PCN offers you a lot of control and opportunity to transform your practice, you will need the BMA to support you to make the most of the opportunity.

As I’ve said previously, if you haven’t looked through the below documents, please familiarise yourself with what the new contract offers you.

  1. Contractual documents
  2. BMA guidance
  3. PCN Blogs

Richard, Mark, Farah and I will be continuing to do a large number of GPC contract roadshows, hosted by LMCs in the coming weeks explaining the details of the contract.  Please do come and attend these and share your thoughts with us.

In the next few weeks, we will add more blogs on the following topics:

  1. Making the most of the funding available for PCNs
  2. PCNs and the LTP
  3. Troubleshooting for PCNs

Get talking with your colleagues around you.  Get talking with your LMC to make sure that you get to lead this journey.  Get in touch with the BMA – the national voice of your PCNs – so that you hit the ground running and make it work for you, your colleagues and your patients.

Krishna Kasaraneni is a member of GPC executive

Sian HeaphyThe one-stop shop for primary care networks
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Primary care networks (PCNs) and workforce expansion

As the contract roadshows continue, discussions about PCNs and how the new workforce expansion will support GPs and practices are creating much debate.  Naturally, there is a wide range of opinions on this from ‘Haven’t we heard this all before’ to ‘Why are GPs and nurses excluded from the workforce reimbursement’ and also interspersed by others who already work with an expanded workforce team that are concerned that they won’t be able to capitalise on the new opportunities that this offers them.

So, the first point – why are GPs and Nurses excluded from the workforce reimbursement?  Well, to answer that, first and foremost we need to be clear about what the PCN DES is intended to do.  Our vision of the PCN is that it helps expand the workforce team beyond the current numbers.  It is no secret that is the biggest issue in general practice – unless we have more bodies on the ground to help us with the ever-increasing workload, we will not be able to turn the tide.  Added to that, the last thing we want to do is remove GPs and nurses from practices who are the nucleus of general practice to work at a PCN level.  That would be analogous to removing the building block of the foundations to cover the roof – it won’t stay up!

There is no general practice without GPs, nurses and the legions of staff that help us run our practices every day.  The PCN DES is not about substituting them, but is about taking some work off them to make the system more sustainable.

That brings us to the promises that we’ve heard before – the extra 5000 GPs and other commitments.  For the first time in a while, you will see in the contract document that there is an acknowledgement that this target is not that easy to achieve. An honest conversation is the first step in addressing the problem and that is what we have in this deal.  Whilst any target would be ambitious, and the progress would be slow, the fact that we are now working together to make sure that GP practices get the extra support, shows that this is a joint ambition and commitment that underpins this year’s contract deal and one that we will work together to achieve.

What are we aiming for?  We are aiming for every single practice to have a Clinical Pharmacist working for them in the next 5 years as part of the PCN.  We want Physiotherapy Practitioners in every single practice to be the first line of contact for patients for musculoskeletal problems.  We want Physician Associates in practices to support the work GPs are currently doing and take some of the burden off the current workforce.  We want Paramedics to be shared between practices who can assist them with appropriate clinical work in practices and with the home visiting services that they are trained to do.  We want Social Prescribers to assist GP practices with patients who are having to deal with challenges that extend beyond ‘health’.

Will we hit the targets for the workforce expansion in the next 5 years?  That is mostly up to us.  Whilst the policy and political environment is not entirely in our control, the determination and vision to help ourselves is firmly in our control.  Therefore, we will need to try our best to make this work for us.  And remember, we are in control of this.  The Clinical Director role for PCNs is costed on a GP performing the role.  The PCN agreement realigns the narrative of putting clinicians in leadership roles and that is an opportunity to make it work for our practices, our staff and our patients.

As I’ve said previously, if you haven’t looked through the below documents, please familiarise yourself with what the new contract offers you.

  1. Contractual documents
  2. BMA guidance
  3. PCN Blogs:
    Primary Care Networks
    The right structures for PCNs
    LMCs and PCNs

Richard, Mark, Farah and I will be continuing to do a large number of GPC contract roadshows, hosted by LMCs in the coming weeks explaining the details of the contract.  Please do come and attend these and share your thoughts with us.

In the next few weeks, we will add more blogs on the following topics:

  1. BMA central support for PCNs
  2. Making the most of the funding available for PCNs
  3. PCNs and the LTP
  4. Troubleshooting for PCNs

So, if I may leave you with Churchill’s quote that was referenced at a GPC meeting recently – “If you are going through hell, keep going”.  That is something every single one of us can relate to in terms of the out of control workload in recent years.  The workforce expansion is our opportunity to address this.

Krishna Kasaraneni is a GPC executive member

Sian HeaphyPrimary care networks (PCNs) and workforce expansion
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