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GPs buried under trusts' workload dump

PCNs are a chance to redefine general practice and feel empowered about the future

Dr Krishna Kasaraneni

It’s sometimes overwhelming to think about how much the NHS has changed and the medical advances it’s helped to achieve.

Since its beginnings in 1948, we’ve seen the birth of the modern hospital, the UK’s first heart transplant, and the creation of the organ donor register – milestones that transformed the face of our health service and how it’s both used and worked in.

In 2019, we’re now on the cusp of another change. Today, patient demand is enormous - our population is growing, people are living with more long-term conditions, and there is greater demand for care where our patients want it, which is at home and in the community.

Just as before, the NHS has to flex to the times it’s in, which is why we’re seeing a massive shift in the way general practice looks and operates with the introduction of primary care networks (PCNs) in England, designed to help us meet growing patient demand.

The concept isn’t new, but the support and safeguards surrounding them are, and there is now guaranteed, recurrent, national funding available to enable us to work together, that we didn’t have before.

I understand that it can be difficult to remain optimistic in general practicebut where collaborative working structures already exist, the benefits to staff and patients are clear - and six months on from their introduction, most of the nearly 7,000 GP practices across England have taken up the PCN directed enhanced service.

This is a time of opportunity; a chance to alleviate workload, close capacity gaps, and most importantly, deliver the kind of care we want to be able to give our patients.

PCNs might be up there with the introduction of modern hospitals, heart transplants, and the organ donor register

Being part of a PCN obviously means working closely with other practices and pooling resources, but it’s also about independence and shaping your network to how you see it serving your community best and help you to manage your workload.

Deciding how to do this, or indeed how to even run a PCN, can be challenging and, as with most widespread changes, there is normally a period of just trying to get your head around it all, including getting to grips with new paperwork, terminology and jargon.

As a GP and executive member of the BMA’s General Practitioners Committee, I understand this, but want to make sure that we, as a profession, head towards change feeling empowered - not disenchanted and blindly following the orders of what someone else thinks a better NHS looks like.

We must remember that this is an opportunity for us to redefine general practice in a way that suits our teams, our practices, and our communities. We are in the driving seat and have the chance to set a new course for the future direction of primary care.

Practically, PCNs provide a viable alternative to current working models in general practice in England, but they are so much more than that. With closer working comes better communication, better patient care, and ultimately, a better NHS.

And you never know, one day PCNs might be up there with the introduction of modern hospitals, heart transplants, and the organ donor register.

After all, for the millions of patients we see every year, this one system change really could be life-changing.

For more information about how to run a PCN, sign-up to the BMA’s PCN Support Proposition here.

Dr Krishna Kasaraneni is a GPC executive member at the BMA and a GP in Sheffield

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Readers' comments (20)

  • Dear Krishna (GPC executive member at the BMA) can you just send me one of those colouring books (or BMA equivalent). Thanks in advance!

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  • Who's he trying to convince? How about the basic laws of supply and demand?.... So glad I emigrated.... scary thing is I sometimes think these people actually believe what they are saying.... I wonder what they're smoking in London?....hang on..wasn't there an association between traffic fumes and dementia? Have the NHS management brigade not worked out yet that these kind of speeches just get met with complete cynicism???? So much for the quality and insight of their leadership courses if they still think that writing these speeches is in anyway helpful..... and no PCNs are not going to be remembered in admiration for their 'life-changing' impact on patients,(Sorry Krishna but you're never going to rank alongside Christiaan Barnard)..... PCNS will just be remembered by GPs as yet another folly which added to their reasons to leave the NHS. As students we might have been inspired by Benton in ER, George Clooney, House, Greys anatomy... a whole host of things that made medicine look interesting, intelligent and fun..... whereas discussing PCNs and structural re-organisation on the TV would have merely sent the viewers into catatonia or reaching for the remote control...... unfortunately in the NHS today when we open our eyes in the morning the nightmare is still there..... and no matter how much we want to change the channel we keep hearing the same deluded ramblings from our 'leadership'. When the readers are contemplating how to spend their winnings from the PCN jackpot consider this..... today I saw an 18 yr old patient at 09:00am with right upper quadrant pain (Normal obs, no guarding, no rebound) of 3 hrs duration, blood results within an hour (Normal) had their US at 11:00am (Strange appearances on liver- obs still fine) and then CT scan ( GP ordered) by 14:00.... I had time to watch the scans being performed between other patients, as the case was unusual, a case of ischaemic bowel (ascending colon), lactate now 3.2.... in the UK I think as a GP I would have no chance of making this diagnosis in the same time frame and the patients outcomes would have been similarly diminished........ so tell me again why its so good to be a GP in the UK Krishna????? It comes down to resources..... without a substantial increase in resources General practice isn't heading anywhere in the UK..... GPs don't want to hear your aspirations and pipe dreams for the future.... they need a tangible and sizeable increase in resources delivered now..... until thats been delivered everything else is just hot air..... and given its been in the high 30s in the NT the last few weeks I know hot air when I see it.....

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  • National Hopeless Service

    WTF - It has become the usual NHS meeting'fest and to me seems to me about dumbing down to the level of the most useless local practice.

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  • No not really..

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  • Cobblers

    Quote;

    "We, as a profession, head towards change feeling empowered --- not disenchanted and blindly following the orders of what someone else thinks a better NHS looks like".

    PCNs are most certainly the latter thought.

    What a load of platitudinous drivel.

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  • Pathetic ~BS,PCNs are a preamble toward HMOs and then a USA style health system and as the NHS is unsustainable on the current funding model it will become the worst co-payment system in history welcome to being a province of the USA health conglomerates.Idiots non entities in leadership roles like this will have lead us there.Thanks for nothing BMA.

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  • We were forced to form PCNs in a very short amount of time!
    Simple rule: Systems work better when they develop organically and people feel they have ownership of them. Forcing people to 'work together and play nice' is rarely a success.
    I suspect PCNs will go the way of so many other NHS re-organisations and quietly fade away at the next change of government.

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  • What planet is he on!!!! Networks will help to reduce workload - really

    Has he seen the indicators that need to be hit and the extra work involved

    Completely out of touch

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  • @ Gp712 | GP Partner/Principal11 Oct 2019 11:23am

    ‘What planet is he on!!!!...........’

    Maybe the air is thin at the top of the greasy pole?

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  • He needs a reality check. How about some risperidone for him? QoF, appraisals, useless meetings, PCNs, CCGs, CQC, GMC, NHSE etc, etc + pay to work and get poorer doing more. A very toxic climate for practice and we are supposed to feel optimistic? I think I need some fluoxetine after this.....hang on, manufacturing problems apparently....try BMA counselling.

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