PCN clinical director – all you need to know

Dr Sarit Ghosh is the clinical director of a PCN in Enfield, north London. He explains how to get in the role and what you can expect 

How do I get into the role (including necessary qualifications)? 

Credibility and trust are key, as a clinical director will often be representing their colleagues. A GP who is a strong clinician with working knowledge of the business and understanding of day-to-day primary care is essential for the role. On top of this, understanding how the NHS works across different sectors (primary, acute and community) and how they interplay is an advantage.  

To understand the system, it helps to be curious around how things fit together and being articulate and brave to get points across in public meetings. Often a clinical director is an advocate for resource and champion for change so being confident enough to defend or propagate a position is key. Training in commissioning and leadership may help but I found a certificate in business administration particularly useful. 

How much does it pay?  

The original funding pot assigned to clinical directors was around 73p per patient, with an expectation of 0.25 WTE for 50,000 patients. This would work out to a salary of approximately £13,000 per session, slightly more than a salaried GP in many areas around the country. In my view, this was not commensurate to the responsibility of the role. However, the actual pay will vary from PCN to PCN, with some opting to top up pay once the ‘Leadership and Management’ and ‘Clinical Director’ funding streams were all combined with the core PCN funding.  

How much time do I need to devote to it?  

As above, it is supposed to take up about a quarter of a full-time role for PCN with a list size of 50,000 patients. But like all leadership roles, there is mission creep in scope, with the need to juggle many different workstreams, be accessible for other members of the team and external stakeholders, as well understand resource allocation and financial management. 

What’s good about the job?  

It’s a real opportunity to engender change at the population health level and redesign local service to fit the needs of your patient demographic. This can be very rewarding as well as the opportunity to work with a wide multidisciplinary ARRS team helping support them to integrate with practice teams and deliver high quality care. 

What’s bad about the job?  

It can be high pressure and there are lots of expectations on you. Like any leadership role in primary care there can be challenges with change management as practices remain autonomous within a PCN and understandably may often have their own priorities. Trying to support individual practices and be balanced to the needs of the collective can lead to difficult scenarios and decisions. Fortunately, having open and honest conversations can often resolve these issues and helps strengthens the bonds within practices in the PCN. 

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