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PCNs need to ensure they are at the heart of integrated neighbourhood teams as they take shape, says Pulse PCN editor Victoria Vaughan
Professor Claire Fuller’s Next Step for Integrating Primary Care: Fuller Stocktake Report, published more than a year ago, established a direction of travel for primary care and an idea of how to get there – by setting up integrated neighbourhood teams (INTs) – but it definitely wasn’t prescriptive.
What an INT is, and how it links to PCNs is undefined but by degrees it’s becoming increasingly clear.
INTs won’t replace PCNs, as national director for primary care Dr Amanda Doyle, told our sister publication Pulse, but PCNs do play a key role in an INT. While this may not be as cast iron as a contract, it is reassuring to hear.
Pulse PCN’s Autumn issue cover feature looks at examples in Surrey and in Leicester, Leicestershire and Rutland (LLR). In Surrey, the INTs have focused on a group of high-intensity users across a place. They have been tackling admission rates by catering to the patient in a more holistic and personalised way through PCN frailty hubs.
In LLR, the work is being led by the integrated care board (ICB) and involves bringing PCNs together in localities and merging them into INTs, while retaining them as organisations that employ additional roles reimbursement scheme (ARRS) staff.
A couple of things are worth noting. First, LLR sees this work as a natural extension to what’s already being done. ARRS staff have moved care beyond the NHS as care co-ordinators and social prescribers engage more widely with services that are better suited to certain patients’ needs and, where successful, they remove some of the burden from GPs. This should assure PCNs that the work they have done will not be scrapped but extended.
Second, in Surrey the plan benefitted from seed funding from the ICB. It is crucial to understand that funding will be needed to support new ways of working. This should give PCN leaders pause for thought as they will have to help articulate the need for, and direct that funding.
INTs are coming but the form they take will vary massively. They need a vision, strategy and leadership. PCNs need to be at the heart of this to remain relevant and ensure there is a focus on the priorities for patients in their locality.
The Fuller Stocktake states: ‘The role of PCN clinical directors (CDs) in the future will be essential to the leadership of INTs.’ It called for more support for leadership development and ‘local provision of sufficient protected time to be able to meet the leadership challenge in INTs’ beyond the current contract.
CDs could think about the role they wish to play in their area’s INTs and what they would need to take up that role, or how they could support a fellow PCN CD to represent them in this space. Could it be more time or more training? If so, they should make the case for that to the ICB, if it’s not happening already.
And PCN leaders can find out and articulate what their network and component practices would like to achieve from being part of an INT. The time for watching and waiting is drawing to a close.