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Having reported on the NHS for over a decade, I am not surprised to see a new cycle of reorganisation. However, no one could have foreseen the emergence and impact of Covid-19.
Forged in this fire, clinical directors (CDs), leading the charge for PCNs, came together at unprecedented speed. In just months, they accomplished work that would have taken years. Practices swiftly set up their red/blue, hot/cold, Covid/non-Covid sites, working together to stop the spread – aided by the links already made in the PCN.
Now they are running vaccination sites and finding these are preferred by some patients. They are visiting homeless shelters to vaccinate underserved populations. They are on the phones, reaching out to hesitant vulnerable and deprived patients. All alongside their daily GP and PCN business.
Much of the thanks should go to PCNs – which are making waves, even though they are drowning in demands.
The inspiration for this supplement was the report I wrote for Pulse: Primary Care Networks: Controversy, Covid and Collective Working, on the state of PCNs after their first 18 months. Through the interviews, I saw recurring concerns: the size and scale of the task; the restrictive nature of the additional roles reimbursement scheme; and how PCNs fit into the system.
In fact, the publication of the White Paper, Integration and Innovation: Working Together to Improve Health and Social Care for All, signifies the increased importance of PCNs with the wider NHS. The 80-page precursor to the Health and Care Bill sets out the stall for the NHS, public health and social care system to ‘connect, communicate and collaborate’.
But contrast this aim with the Covid vaccine rollout – the disconnect between expectations and supply at mass vaccination sites, PCN sites and pharmacies – which PCN CDs discuss in our roundtable.
The White Paper mentions PCNs twice. The first is when it allows the formation of joint committees between commissioners and providers, which ‘could include representation from other bodies such as primary care networks, GP practices, community health providers, local authorities or the voluntary sector’. The second mention restates a commitment to the ‘primacy of place’, with ‘shared priorities’ and ’place’ as a primary focus for PCNs.
PCNs will have a vital role in shaping the agenda – if their voices are heard. Therein lies the challenge – working together across a single PCN is already difficult in some areas. Combining roughly 10 PCNs to create a unified primary care voice across the ICS board, while keeping local focus, will be no easy task.
ICS leaders I spoke to recognised the value of PCNs, which allowed them to manage the pandemic more effectively. The first two years of PCNs were defined by setting up and Covid. But as PCNs come into their third year they can embed the work they’ve done and focus on their future priorities to deliver agile and responsive care. But they must be supported and listened to – and I hope this supplement will help.
Victoria Vaughan is editor of PCN