Half of ICBs don’t think PCNs are able to deliver on ICS strategies

Half of integrated care board (ICB) leaders think PCNs do not have enough resource to deliver on ICS ambitions, a national survey of ICB leads has suggested.

Led by the NHS Confederation, the survey found that 24% did not think that PCNs had enough ‘resource and maturity’ to support their integrated care strategies, while 31% were neutral. Around two-fifths (44%) felt PCNs were well resourced.

Integrated care strategies – in place in all 42 ICBs – set out aims and actions to reduce disparities in care, manage population health and explore personalised care.

In its annual report, The state of integrated care systems, the Confederation found that primary care leaders agreed that there were ‘unrealistic expectations’ of PCNs.

One ICB chief executive said there is an ‘over-expectation of what PCNs can deliver’ with their ‘existing infrastructure and leadership capabilities’, rather than being a vehicle for transforming primary care.

The report said: ‘Both ICS and primary care leaders are clear that PCNs will need the autonomy and support infrastructure to allow primary care leaders to play a more active role in ICSs.’

It added that PCNs will be ‘a key partner in improving population health and building neighbourhood resilience’.

That same survey found that 77% of ICB leads agreed trusts had the resources to support their ambitions, and 49% agreed the same for provider collaboratives.

Chair of the Confederation’s PCN advisory group, Professor Aruna Garcea, said: ‘PCNs are increasingly being asked to take more of a leading role which is no surprise as they are the building blocks to integrated care systems and central to their success.

‘However, we agree with ICS leaders that as capacity pressures and expectations on PCNs increase so too must resource, capabilities, and trust. The Fuller Stocktake offered clear tangible recommendations for systems and national decision-makers that would improve the ability for primary care to integrate and drive ICS strategies but there has been variation in the pace of delivering against these recommendations.

‘Without long term funding stability and security for PCNs and the new roles that are enabling PCNs to deliver care across a community, this will be more difficult and hinder any improvement. We must also recognise the important role of at-scale infrastructures such as GP federations and provider collaboratives to support resilience of general practice and PCNs as well as contributing to primary care maturity and system leadership for primary care.’