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Network overload

It might be forgotten by some, but the pre-Covid workload concerns have not gone away.

So the fact that primary care network clinical directors are suffering from workload issues – with a high level of turnover – should come of no surprise. These are jobbing GPs who now have extra duties, so I can’t understand how it could be any different.

This isn’t going to get any better. Currently, there are no service specifications in place – it has only been setting up the networks. But by the end of July, the care homes element of the Network DES is going to begin, and PCNs will need to be performing weekly ward rounds by October. At the same time, they will need to implement the medicines review element. And then there will be more specifications introduced in the coming years.

There is no turning back from PCNs

It’s true that clinical directors are being given a bit of funding for their time, and they’re advertising for/recruiting/training/organising staff under the ARRS scheme. But this funding doesn’t do much if there are no GPs to employ, and the ARRS staff are roles they weren’t sure they wanted or needed in the old normal and it is even harder to dovetail them in now.

There is no turning back from PCNs – there is too much invested both literally and figuratively to dismantle the structures now. But I still remain to be convinced that this will do anything to alleviate the structural problems within general practice. Indeed, by taking people away from frontline practice and heaping more managerial work upon them, PCNs may well be exacerbating the issues.

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at

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