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PCN workload leading to ‘burnout’ and ‘high turnover’, says NHS body

Primary care networks in England are shouldering heavy workloads that are leading to ‘burnout’ and a ‘high level of turnover’ among their clinical directors, the NHS body representing health service providers has found.

In a new NHS Confederation report published today, the body’s PCN network said clinical directors must be given further support to mitigate workload issues, including leadership training and funding for non-clinical managers under the PCN additional roles scheme.

The report, which looked at PCNs one year on from their launch in July 2019, said the ‘overwhelming pressure that has been placed on the shoulders of staff’ has meant that ‘in some areas PCNs have yet to make significant impact’. 

It added:‘The workload for PCNs has been heavier and more stressful than many anticipated, with much of this work falling to the clinical director. 

‘Huge pressure has been put on those working in PCN teams, exacerbated by Covid-19, and many clinical directors are concerned that it is not sustainable.’

The NHS Confederation added that ‘concerns have understandably been raised around burnout among clinical directors’.

‘If we are to address the high level of turnover among clinical directors, then they must be given further support’, it said.

Dr Mark Spencer, NHS Confederation PCN network co-chair and clinical director of Fleetwood PCN, told Pulse that leading a network has been ‘overwhelming’.

He said: ‘As a clinical director, we’ve been pulled in so many different directions. Some of our clinical directors are fairly new to leadership [but] it’s been overwhelming at times, even for seasoned leaders.’

Ruth Rankine, director of the NHS Confederation’s PCN network, stressed that around half of clinical directors are in their first clinical leadership role.

The network has been pushing for both investment in dedicated managers for PCNs as well as leadership training for clinical directors, she said. 

Ms Rankine told Pulse: ‘The manager role will help to free up the clinical director time so that it is spent where it needs to be spent and not doing some of the more managerial functions.

‘Equally it is also about investing in the clinical directors and their leadership capability that really supports those people in those roles. We need to invest in their development to really become strong primary care leaders.’

An NHS England spokesperson said it will ‘continue to support and develop PCNs and clinical directors as they strive to improve access to high-quality primary care’.

They added: ‘PCNs were at the forefront of transforming services in response to Covid and as this report states, staff are still optimistic and will be able to build on the ‘notable success stories of networks delivering tangible benefits for the health of their populations’ including ‘allowing more patients to be seen during the Covid-19 pandemic’.  

Last month, NHS England announced that 98% of GP practices have signed up to the primary care network DES this year – although a Pulse analysis of data supplied by CCGs showed that a slightly larger number of practices have opted out this year compared to last.

It followed the collapse of one PCN – serving 80,000 patients – due to concerns about the care homes requirements of the network DES, while others warned they were ‘in danger of folding’ over similar concerns.

And a report from Pulse’s publisher Cogora revealed in April that more than a quarter of GP partners in England spent an average of 10 hours or more a week establishing their networks in 2019.

Earlier this year, one LMC told their practices that they could not advise signing up for the DES due to workload requirements.

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