Three quarters of PCN clinical directors say 2020/21 resources ‘inadequate’

Seven out of 10 clinical directors believe the resources being given to primary care networks (PCNs) in England for 2020/21 are inadequate for delivering the DES, a new survey has shown.

The Pulse survey of 179 PCN clinical directors also revealed almost two thirds have so far been unable to recruit all of the extra clinical staff that PCNs are entitled to for 2020/21.

It comes as one in 10 of the directors said they believe they will be unable to fulfil the new care home service being delivered in full as part of the PCN contract from this month.

Meanwhile clinical directors reported spending on average 2.5 hours a week on PCN duties, which they said means losing around 19 appointments.

GPs told Pulse the prospect of delivering the three new PCN services – covering care homes, structured medication reviews and early cancer diagnosis – is ‘overwhelming’ at a time when hiring extra staff has been challenging.

However, the vast majority (85%) of clinical directors said they are either ‘likely’ or ‘very likely’ to continue with the DES in 2021/22.

Pulse and its publisher Cogora conducted the survey of PCN clinical directors between 25 August and 14 September.

A total of 72% said the resources for PCNs in 2020/21 were not adequate, while 21% said resources were sufficient and 7% didn’t know, according to the 163 clinical directors answering the question (see chart, below).

An extra £3.7bn of funding has been committed by NHS England to help PCNs recruit 26,000 extra clinical staff by 2023/24.

In 2020/21, PCNs are able to recruit extra staff from a pool of 12 different clinical roles – up from two in the previous year – using funding from the additional roles reimbursement scheme (ARRS).

But Pulse’s survey revealed 64% of clinical directors had so far been unable to recruit all of the extra staff their PCN is entitled to under the ARRS in 2020/21, while 26% said it had been possible to recruit and 10% said they didn’t know (see chart, below.)

According to 10% of PCN clinical directors, it will not be possible to fulfil the care homes DES requirements from this month, with a further 26% saying they are unsure – though 64% said it would be possible.

Newham Central PCN clinical director Dr Farzana Hussain said a lot of anxiety remains about delivering the three new service specifications that begin in full this month.

She said: ‘I think they are the correct content – cancer, structured medication reviews and particularly care homes are absolutely right – but it does feel a bit overwhelming still.’

Lancashire GP partner Dr Russell Thorpe, who chairs the Lytham St Annes PCN meetings, said it was difficult trying to recruit clinical staff under the ARRS.

He said: ‘We’re building a team but we’re all in competition with the other people playing the game.’

Dr Hussain added: ‘London weighting is not included so it’s really difficult to attract those people to come. The reimbursement just doesn’t cover that. So if we don’t put our own money in, we’re not going to get anybody.’

A spokesperson for NHS England said: ‘PCNs are receiving more than £700m this year, we have raised the reimbursement rate for new staff, increased the number of roles within PCNs six-fold, and are providing other support to networks to support and expand their workforce.

‘PCNs have played a vital role in the response to the coronavirus pandemic, and we will continue to support them to deliver important improvements to patient care.’

PCNs faced difficulties recruiting staff under the ARRS last year, when two roles were available.

Pulse previously revealed only half of networks had recruited clinical pharmacists, with a similar proportion having managed to hire social prescribers in 2019.

Meanwhile, practices have reported spending around three hours a week ensuring care homes receive virtual ward rounds, after NHS England brought forward this element of the new PCN care home service during the pandemic.