PCNs: The end

Editor Victoria Vaughan reflects on the end of the five-year PCN Network DES – and a major change for Pulse PCN magazine

As 2023 draws to a close there are a number of significant endings on the horizon. For Pulse PCN, our Winter issue marks the twelfth and final print magazine as we move to a fully digital format. And the five-year PCN Network DES ends in March 2024.  

Looking back on our coverage there are three major changes that PCNs have overseen. First, practices have come together across dividing lines. Second, practices are caring for patients in a more proactive way, as seen in the profile of Cheltenham Central PCN in this issue. Third, there is a wave of new recruits into primary care under the additional roles reimbursement scheme (ARRS). 

This final change has been the most controversial. If judged by the government target of hiring 26,000 new recruits, it’s been a success. At the last count, the figure was 31,000. But people in posts doesn’t equal success. They have to be the right people, with the right support and space to free up GP time and increase patient access. Opinion on that is divided. 

I’ve heard clinical directors say it is wonderful that they can use care co-ordinators to reach people they know are underserved. That mental health practitioners have provided more appropriate care and freed up GP time. 

I have heard others lament the training burden, the inflexibility of the specified roles and the pressure on estates. It seems that ARRS roles have turbo-charged primary care only if PCNs were already in a good place. 

More broadly, the ARRS has put pressure on community pharmacy as pharmacists are the most hired role. There is controversy about GP associates. And Dr Katie-Stainer, chair of the BMA’s GP Committee, recently suggested GPs should act as gatekeepers to the roles – because GPs can deal with more than one issue in an appointment and prevent misdiagnosis. 

This year’s NHS Long Term Workforce Plan further endorsed the scheme, committing to increase the number of non-GP direct patient care staff by around 15,000 and primary care nurses by more than 5,000 by 2036/37 and establishing a workforce of 10,000 physician associates by 2036/37. 

Whatever fate holds for PCNs, the ARRS is not fading away. Neither is the need for better use of primary care. The NHS Confederation recently concluded that every £1 spent in primary care equates to £14 in economic growth, so investing £1bn boosts the national economy by over £14 bn.

Although this is the last print issue of Pulse PCN, we too, will not be fading away. To reflect the changing media landscape and to deliver our stories more immediately we will continue to provide news, views and analysis at pulsetoday.co.uk/pcn and via our newsletters and events. We have always been about serving GPs who see the opportunities created by PCNs. Primary care at scale has always been a place for policy makers to tinker – primary care groups, primary care trusts, clinical commissioning groups, PCNs – but the facts don’t change. It is cheaper to treat people in primary care than in hospitals, patients don’t want to go to hospital unless it’s vital and GPs sit at the heart of each community. We continue to serve the leaders of that community.