Four tips for building a team beyond the PCN 

Since the publication of the Fuller stocktake report on the next steps for primary care there are many networks who are onboard with the concept of building their integrated neighbourhood team.

The report described this as: ‘A healthcare team that brings together a variety of healthcare professionals and organisations in order to provide comprehensive care to patients’.

For example, you may:

• Have commissioned a provider to support your pharmacist provision
• Be working with a third sector company to support social prescribing
• Have good links with a community campaign to support your vaccination campaign
• Have a community cardiovascular service that includes staff working from a practice, alongside colleagues from secondary and community care
• Simply know who to call in your local authority or business community to cascade patient information quickly

For others, you may still be in the early phases of building your current team (which is perfectly normal and to be expected in this complex environment).

Wherever you are, this article we will explore four practical principles to help build your team and connections beyond additional roles.

Disclaimer

It’s worth noting the principles may be simple on the surface, but the seasoned leader understands the intricacies of working across boundaries that pull on different commissioning pathways, timeframes, and organisational cultures.

1. Build on what you already have

While many PCNs may not have defined integrated neighbourhood teams; I encourage networks to look a little deeper and review your current partnerships. You may already have a regular forum or working group you can build on.

I recently attended a PCN meeting looking to strengthen its frailty provision. They were quickly able to list a wide range of organisations and people they could collaborate with. In many respects, they were already working together, but there was room for improvement.

In another PCN, they were looking to improve the coordination for the ward rounds, which are part of the advanced care in care homes service specification. They have been struggling to recruit a care coordinator and are now looking into a part-funded role using a member of the care home team.

These conversations were born out of gaps in services, efficiencies and frustrations and a lack of understanding of where each party was coming from.

They did not sit down and say we want to build an integrated neighbourhood team.

Start small and build on what you already have.

2. Look for best practice.

One thing the healthcare sector does well is share the good, bad and the ugly.

There are countless WhatsApp groups, Facebook groups, 24-hour social media news cycles, blogs, articles and reputable publications providing the outlet for us to ask for advice and for our peers to share.

Use this data to inform your next steps.

In preparation to write this article, the first thing I did was Google how to build an integrated care team, and 10,300,000 results were generated in 0.34 seconds.

We are not walking a path others have not tried before, and while the challenges are plentiful, different professions and organisations can work together to deliver more joined-up care.

As a seasoned leader, you are already acutely aware that it’s not a simple drag and drop of one idea from one area into another but learning from others will help you sow some seeds.

Where could you go to access new ideas and lessons learnt?

3. Seek Clarity

Below is a list of exploratory questions for you to consider.

I appreciate that there are a lot of questions here, and not every one needs to be answered, but when looking to establish or strengthen partnership working, creating a framework of questions will help to provide a shared vision, clarity, and some meaningful next steps could be incredibly helpful.

During your PCN meeting or protected learning time sessions, choose a few questions to consider:

1. What are our priorities?
2. What are we struggling with?
3. Who else may share a similar challenge?
4. Who else may have a solution?
5. What do we want to achieve?
6. What are the barriers?
7. Where does it make sense to collaborate?
8. What further information do we need?
9. What are the benefits?
10. What do we need to be mindful of?
11. What can we tie this too without creating an entirely new workstream?
12. What is working well?
13. What could be even better?
14. What resources could we use?
15. What infrastructure and access do we need?
16. What data do we have to inform our decisions?
17. What would I/we/you need to give up to make this happen?
18. What do our patients need and want?
19. Who is responsible and accountable?
20. Who needs to be consulted and informed?

Definitely include the final two questions in your discussion.

Try not to force areas for partnership and be patient as that will only result in much effort going nowhere.

The cost-of-living crisis and the impact on health inequalities, mental health and additional strain put on services in the winter could provide the opportunity for more parties to collaborate, and maybe social prescribing could be a good place to start.

What questions resonate with you from the list above, and what is the next step?

4. Identifying key people of influence

To make this new or developing partnership a reality, you will need key people of influence to drive this forward. In fact, you will need four.

In both camps you will need a passionate and visionary individual, with the ability to sign off financial decisions and influence pathways.

In both camps you will also need an implementer. These are the people that make things happen, are excellent at communication and understand the logistics and operational elements which need to be in place.

One party will inevitably lead but you need this steering group to make things happen on both sides.

Tara Humphrey is the Managing Director at THC Primary Care, providing project and network management and training to Primary Care Networks. Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care and is the author of more than 200 blogs also hosts The Business of Healthcare Podcast.