Primary Care Networks (KF 0319) (GP Practices working at scale (lots of…
Primary Care Networks (KF 0319)
GP Practices working at scale
lots of different ways in the past, super-partnerships, federations, clusters, networks
defined in nhs LTP and new GP contract (0419)
all practices to be in a network (0619).
networks are similar to size of primary care homes, but smaller than federations
30-50,000 populations (with no upper limit)
Building block for NHS long-term plan.
0618 announcement of new money large portion will be channelled through networks
DES direct enhanced services payment, extension of core GP contract, and being offered to all practices. worth upto £1.8 billion by 2023/24.
= money to operate network and £891m to fund new staff (roles imbursement scheme.
contract between commissioner and individual practices - and money channelled through a single bank account by the network.
current fund for providing enhanced access services, aid to GPs to give consultations out of core hours, will transfer to the DES (0421) (from an agreed list of suppliers on a new separate national framework).
Additional Roles Reimbursement Scheme
= part of DES, funds 70% to cost of new clinical roles (100% of social prescribing link worker to be funded); networks decide on numbers.
improve practice staff recruitement and retention
manage financial and estate pressures
provider a wider range of services
more easily integrate with wider health and care system
only way to access additional funding attached to GP contract.
Service Delivery vehicle for LTP and offer wider range of services
New staff roles
Funding 19/20 for clinical pharmacists and social prescribing link workers
Shared services across a network
first contact physio, physician associates 20/21 and paramedics 21/22
Integrated community based teams
to be develop to this footprint
community and mental health services expected to configure their services to these boundaries
service people with more complex needs, with proactive and anticipatory care
Wider health of the Popn.
proactive approach to managing pop health
20/21 assess needs of local pop and deliver targeted proactive support
integrated care systems
planning and funding of services,still responsibility of commissioners, building blocks for the ICSs.
PCNs are the mechanism for making primary care representation stronger - with accountable clinical directors from each network being link between GP and wider system.
Deliver 7 national service specifications
structured medications review
enhanced health in care homes
anticipatory care (with community services)
supporting early cancer diagnosis
cardiovascular disease case-finding
local agreed actions to tackle inequalities
approx. with CCG boundary (unless existing well-funded federation) , tho can cross boundaries and a practice could belong to more than 1 PCN
network-based services have to be accessible to entire population
practices not joining will lost out on funding and neighbouring networks given the funding to provide services to those patients.
Practices accountable to commissioner, for deliveing 'network services'.
Practices in network sign legally binding network agreement
Agreement could set out wider objectives, involvement of partners (community health, pharmacy).
Comisioners could remove DES entitlement if they don't deliver serivces, but rare.
Identifies Accountable Clinical Director
primary focus - voice upwards and single point of contact for wider integrated care system
appointed by the network
In the past, success when generated organically, over years, underpinned in trust, relationships, support and clear focus on role of collaboration
less success, lack of clarity of purpose, aover-optimistic expectations, high cost of shared information systems, complexities around financial liabilities and premises.
Scotland model, new GP contract requirs practices to join geo quality cluster, most effective when focussing on similar QI initiatives
Welsh model, also clusters, flagged over reliance on key individuals and need for greater invlovement of care professionals.
England, networks and Leads will require significant support to build trust and relatioships, resist over optimism in short term.
continuity and trustung relationships
Monies to start to flow - 0719
test-bed sites to test elements of new contract
write new service specs
design innovation and investment fund
development support from the centre.