A quarter of PCNs have formed a company

A quarter of PCNs have formed a company, according to a Pulse PCN survey.

The survey, in which 228 PCN representatives responded, found that 27% of them had formed a company.

Within the 60% who said they had not formed a company, there were five who also said they were either in the process of forming a company or that they were planning to do so.

Another said they felt they ‘may need to do this’, and two others said they had a federation who support the PCN and operates as a company.

Dr Ben Gowland, director and principle consultant at Ockham Healthcare, said that more and more PCNs are forming companies. 

‘The primary driver for this is the employment liability of the ARRS staff – as the numbers of staff have increased the liabilities have become greater, and for PCNs where the employment is held by a single practice it has become too much for them to be comfortable to hold,’ he told Pulse PCN.

‘The company structure means that the practices are no longer directly liable.’

He added that the main downside for this model was the ‘loss of flexibility’.

‘We do not know what will happen with PCNs even next year, and it may harder for those with a company structure to flex to meet the new requirements (whatever they are!),’ he said. 

‘PCNs incur legal costs in establishing a legal structure and then will have to pay out even more to make any further changes that are required.’

He added that another downside was that it reinforces the perception that the PCN is ‘somehow separate’ to practices, rather than an extension of them.

‘This can exacerbate tension where it occurs between the practices and the PCN,’ he said.

There are currently 209 companies registered as active on Companies House who have PCN or primary care network in their name and whose nature of business is general medical practice activities.  

Ruth Rankine, director of the NHS Confederation’s Primary Care Network, told Pulse PCN that it was ‘not surprising’ that so many PCNs have become companies.

She said: ‘It is not surprising that so many PCNs who have been working collaboratively at scale for up to six years have incorporated to develop an infrastructure to deliver the broad scope of the directed enhanced Service (DES). Incorporation can also help support in several other areas such as employment, resilience, and, in some cases, innovation of clinical pathways for local services.

‘Some PCNs have created alliances with each other and with their federations to create larger scale GP organisations to work at scale as GP provider collaboratives for advocacy, influence, and services.’

She added: ‘Incorporation can promote resilience in general practice and provide mutual aid for struggling practices. But it should be done with good legal advice, clear decision making and governance, variation and risk support.’

This survey was done in collaboration with our sister title Pulse and was open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same primary care network, a total of 228 PCN representatives from England responded to these questions. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 John Lewis voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the PCN population.