How are PCNs driving collaboration across the health system? The BMA talks to Leeds nursing leader Steph Lawrence about developments in 2019 and what the future holds. Steph is the Executive Director of Nursing and Allied Health Professionals at the Leeds Community Healthcare and Leeds GP Confederation and is in the rare position of having responsibility for general practice nursing, as well as community healthcare. She will be speaking at the 2020 PCN Conference on 8 February.
How do you assess how PCNs have gone to date?
It’s gone well in Leeds, (there are 18 PCNs in the Leeds area). It was a bit bumpy to start with, but we have now established good working relationships across primary care and community trust level. Leeds is in a strong position as there has been a confederation of practices already in place. It’s pivotal that primary care has one voice.
For me, what’s crucial for the success of PCNs, is good communication and for us to understand what primary care needs.
What practical steps have taken place that you see as positive?
Previously, we tended to pinch staff off each other, (between primary care and community trust). It’s better to understand the needs of both and then explore ways of working together. Now we are starting to have joint posts that are shared – the first example is an advanced nursing practitioner and we are currently looking to fill an additional joint post. We’ve also recently established a joint wound care service in an integrated setting. We’re looking to see if this wound care clinic can drive efficiencies in the system. And, in addition, one of the PCNs is looking at home visiting services, which are shared. It’s a pilot to look at how when a referral comes in it can establish who the right person is to take that on. Just because the referral initially goes to a GP doesn’t mean it’s the GP that should take it up. A community response from a community matron or district nurse may be more appropriate.
What are the main challenges for primary care and for PCNs?
The biggest challenge is workforce and where we get staff from – there is no getting away from that. One method we are looking at is the ‘employ, deploy’ model where the Community Trust takes responsibility for employment but how these staff are then used is led by the practice. This will hopefully support capacity and make things more robust.
We want to try introducing better training for staff such as in long-term condition training. Rather than doing diplomas and courses on one-off conditions we want to develop a long-term condition care package of training. This will mean that district nurses could take on all tasks and aspects of care related to long-term condition management where they are already seeing patients, which will free up time for practice nurses and ensure efficiency and reduce duplication.
What are your hopes for 2020?
My vision would be for us to work more closely in the future across community and primary care. By doing this we can try and take on some of the challenges set by the initial PCN service specifications set out by NHS England at the end of last year. There is a real opportunity to deliver higher quality care. I appreciate that capacity is limited but I do think the goals in the specifications present opportunities as well.
For more information on the conference and to book your place, visit our PCN Conference page