Primary care network

Primary care networks were introduced into the National Health Service in England as part of the NHS Long Term Plan, published in January 2019. The 2019 General Practitioner contract gave the opportunity for GP practices to join networks, each with between 30,000 and 50,000 patients. The stated aim is to create fully integrated community-based health services.[1] By June 2019 1,259 primary care networks had been established across England, with an average population covered of about 42,000 patients, and including all but about 55 practices. About 25 had decided not to participate.[2]

Networks will be required to deliver seven national service specifications. Structured medication reviews, enhanced health in care homes, anticipatory care (with community services), personalised care and supporting early cancer diagnosis are to start by April 2020. Cardiovascular disease case-finding and locally agreed action to tackle inequalities are to start in 2021.

This model was pioneered by the vanguard projects established under the Five Year Forward View. The networks will hold local contracts for enhanced services. They will have 'expanded neighbourhood teams', which the plan envisages 'will comprise a range of staff such as GPs, pharmacists, district nurses, community geriatricians, dementia workers and allied health professionals such as physiotherapists and podiatrists/chiropodists, joined by social care and the voluntary sector'.[3] Each network will get £37,810 to fund a clinical pharmacist post for 2019/2020, which is to cover 70% of the costs, with the network expected to cover the rest. The intention is that each network will have five clinical pharmacists by 2024 – about one per practice.[4]

Evidence of the effectiveness of this approach is rather limited.[5]

Modality Partnership and Our Health Partnership, two of the biggest GP super-partnerships, proposed in 2019 to lead networks across the country, which may include practices not in their organisations.[6]

Staffing

Funding will be provided for the employment of clinical pharmacists and social prescribing link workers in 2019/20, and subsequently for physiotherapists, physician associates and paramedics.[7] It is expected that an additional 7,500 pharmacists will be required in the networks by 2024.[8]

In November 2019 NHS England announced a change in financial rules which will permit networks to meet management costs of the charities and other organisations which supply social prescriber link workers.[9]

References
  1. "Primary care networks are about much more than general practice". Health Service Journal. 6 February 2019. Retrieved 17 March 2019.
  2. "GPs to form 1,300 primary care networks". Health Service Journal. 27 June 2019. Retrieved 23 August 2019.
  3. "New GP contract to mandate practices to join primary care networks". Pulse. 7 January 2019. Retrieved 17 March 2019.
  4. "Every primary care network to get £38,000 to fund new clinical pharmacist role in 2019". Pharmaceutical Journal. 31 January 2019. Retrieved 17 March 2019.
  5. Pettigrew, Louisa; Et, al (January 2019). "Lessons for 'large-scale' general practice provider organisations in England from other inter-organisational healthcare collaborations". Health Policy. 123. doi:10.1016/j.healthpol.2018.10.017.
  6. "Superpractices looking to take leadership roles on GP networks across England". Pulse. 12 April 2019. Retrieved 16 April 2019.
  7. "Primary care networks explained". Kings Fund. 13 March 2019. Retrieved 7 May 2019.
  8. "Number of clinical pharmacists expected to work in PCNs rises to 7,500 by 2023/2024". Pharmaceutical Journal. 16 September 2019. Retrieved 19 November 2019.
  9. "PCNs permitted to pay charities' management costs". Health Service Journal. 27 November 2019. Retrieved 11 January 2020.
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