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Report

Long read

Primary care networks: three years on

The progress, challenges and successes of primary care networks (PCNs) since their establishment in July 2019.

  • Primary care

Download the report $Primary Care Networks Three Years On 208.6 kB

Key points

  • The three years since PCNs were introduced have been tumultuous, including a global pandemic, a wholesale reorganisation of the NHS, rumours of reform to the GP operating model, dwindling numbers of GPs and extremely high demand for NHS services. All this has caused a crisis in general practice, affecting the development of PCNs and rendering them unable to deliver on their stated aims of stabilising general practice, dissolving the historic divide between primary and community services and reducing health inequalities.
  • Despite these peculiar circumstances, PCNs have delivered all – and more - of what was asked of them, including the lion’s share of the COVID-19 vaccination programme, the recruitment of nearly 20,000 additional roles reimbursement scheme (ARRS) staff and the introduction of seven new services, in turn aiding prevention and providing much-needed additional capacity within a stretched health system.
  • In addition to this unstable operating environment, workload pressures and inadequate infrastructure have proven to be challenges for PCNs. However, the workload and urgency of COVID-19 saw rapid adoption of new technologies and ways of working, as well as purpose-driven collaboration within the NHS and communities. Workforce has also evolved, with new ARRS staff bringing both an expanded workforce and new skills while clinical directors have matured into their roles and many PCNs have taken the initiative to recruit other, non-ARRS staff.
  • Despite PCNs now delivering new services their development has not been uniform, with success often being dependent on local factors. This means that systems have a role to play in promoting integration at place through primary care leadership, providing supporting infrastructure and committing to transformation both in empowering PCNs themselves and in recognising that PCNs – as the ‘building blocks’ of ICSs - are the transformation that underpins all others.
  • To remedy the rollercoaster of the past three years, PCNs require certainty and capacity. This includes guarantees for their existence beyond 2024, no further service specifications, increased flexibility within ARRS alongside introduction of an access lead reform of the mental health practitioner role and further support for transformation.
  • Wider policy must also focus on capacity creation through workforce measures, including a fully funded whole workforce plan, pension reform to encourage more clinical sessions and equitable access, as well as capital investment and a focus on research and innovation, particularly in primary care as it will return the highest yield.