Calls for NHS England to ‘guarantee PCNs will exist beyond 2024’

NHS England must guarantee PCNs will exist beyond 2024 to allow for long-term planning, the NHS Confederation has said.

The absence of a guarantee has left many PCNs ‘hesitant to recruit permanently’ into ARRS roles, a scheme which it said should be more flexible and cover training and supervision.

The organisation also called for NHS England to refrain from adding further service specifications to next year’s Network DES.

It comes as part of a major report marking three years since the networks were established in July 2019, which saw PCNs grapple with the Covid pandemic in their first 12 months, followed by the dissolution of CCGs and the move to integrated care boards (ICBs) in July.

This has been underpinned by think tank policy papers ‘touting reform’ of the GP operating model and ballots to withdraw from the PCN contract, it said.

NHS England must work urgently to remedy the ‘unstable operating environment’ PCNs launched into, it said, allowing networks to plan beyond the uncertainty surrounding their own futures.

The report said: ‘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.’

According to the report, the Covid vaccination programme stands as proof that PCNs are ‘effective delivery models’ especially for reaching underserved populations, as does the accelerated progress against digital access targets.

And as of June 2022, PCNs have recruited 19,229 ARRS staff against the 26,000 manifesto target, with the Confederation highlighting social prescribing link workers, care coordinators and health coaches as a ‘significant plus to this gap’ in GP workforce.

The Confederation also welcomed the fact that many PCN clinical directors ‘matured into their roles’, with many taking on roles as primary care partners on ICBs.

Despite their achievements, however, successes are often dependent on local factors, namely how well integrated the PCN is at place level and the supporting infrastructure that PCNs have access to.

Networks have also failed to meet their stated aims to stabilise general practice, dissolve the primary and community care divide and reduce health inequalities.

As the foundation of integrated care systems (ICSs), it is ‘vital’ that future policies are designed with primary care as the starting point, it said, adding that systems should ‘plug any funding gaps’ for PCN development that were lost with the transition to ICBs.

The NHS England-commissioned Fuller Stocktake report, published in May, called for PCNs to ‘evolve’ into Integrated Neighbourhood Teams (INTs) by 2024, with urgent same-day appointments to be dealt with by ‘single, urgent care teams’ across larger populations.

However, current BMA policy is to organise for GP practices to withdraw from PCNs by next year.

As part of its September winter support measures NHS England also encouraged PCNs to continue to recruit, and make full use of their ARRS entitlement ‘with the knowledge that support for these staff will continue’.