Today’s Westminster Health Forum policy conference Primary care in England and implementing the NHS Long Term Plan, 5th June 2019, explored the emerging Primary Care Networks and considered the benefits and challenges that lie ahead for healthcare practitioners and the UK population. It is envisaged that Primary Care Networks will speed up the way that treatments can operate and facilitate those treatments happening in the community.  Patients can expect improved continuity of care, new access opportunities, tailored consultation times, and increased quality of care.

A Primary Care Network (PCN) exists of a core network of practices in a neighbourhood working in collaborative agreement with community teams, mental health teams, Local Authority, the Voluntary sector, hospitals, and specialist services.  PCNs are designed to support the health and wellbeing of the local community, with services reflecting the health needs of that community. It is expected that there will be in excess of 1,000 established PCNs in the UK by 2020.

Watch this short Primary Care Network Animation from NHS England.

PCNs operate with multi-professional teams.  Dr Raj Patel, Deputy Medical Director, Primary Care, NHS England revealed that his practice, The Brooke Surgery, has two paramedics, a practice pharmacist, and a social prescriber.  He commented that expanding services will make it easier for people not to rely on hospitals. 

Translating high level policy into practical day-to-day working comes with challenges.  The responsibility of establishing PCNs has been left open to interpretation to allow services to be structured around the specific needs of the local population.  Dr Rebecca Rosen, Senior Fellow, Nuffield Trust and GP, highlighted that role definition across multiple practices is challenging.  Good recruitment and induction processes are critical success factors and require a significant investment of senior staff time to support, train, and quality assure.

Dr Rosen stated the need for clearly understood boundaries for new roles within multi-professional teams.  She revealed that action learning - setting goals, trying it out, coming back to review, refining as you go along - can be a useful tool for collaborative working.  She shared a personal example of best practice, where the team use technology to improve working practices.  The team look at one item on the dashboard which is achieving good results.  Whoever is responsible shares with the team how it is being achieved so that the rest of the team can take the strategy and adopt it into the working system. 

Multi-professional teams require multi-professional leadership, opening up career pathway opportunities for Nurses, AHPs, Doctors, Healthcare Scientists, Midwives, Pharmacist, Psychologists, and Social Workers.  Dr Crystal Oldman, Chief Executive, The Queen’s Nursing Institute, highlighted the Queen’s Nurse Leadership Programme.  She commented that she hopes to see many nurses take on the role of Clinical Director of PCNs in future. 

Steve Holland, Lead for Primary and Community Care Integration and Head of Market Development and Quality Assurance, Norfolk County Council, said that forging relationships with non-health organisations has played an essential role in the creation of the PCN in Norfolk.  They work with a vast network of organisations across the county including education, leisure providers, community transport, day services, residential and nursing homes, supported living, faith, community providers, unpaid carers, and hospice care.  He commented, “The NHS has not been good at leveraging other organisations for PCNs.”  This will need to be both supported and encouraged as more PCNs are established.

There are a range of healthcare providers that can support greater access to healthcare within communities.  Genevieve Smyth, Professional Advisor, Royal College of Occupational Therapists, described a project at the Solent GP Surgery, where Occupational Therapists (OT) are supporting adults in employment who are off work sick and require a GP Fit Note.  A survey of patients revealed that most patients that were seen and provided with tailored advice were able to return to work before the date noted on the Fit Note. 

She highlighted the role that OTs could play in assessing and providing Fit Notes for patients and suggested a review of the law on who can sign GP Fit Notes could be beneficial.  OTs have specialist knowledge that can provide employers and patients with more detailed information to support a return to work.

Malcolm Harrison, Chief Executive, Company Chemists’ Association highlighted the Community Pharmacy Connection Scheme, which currently has four pilots running in England.  Patients who contact 111 can be referred directly into a community pharmacy to receive medical support for minor ailments. He noted that there is an important role that pharmacists can play in prevention.  For example, patients with a sore throat can visit their local pharmacist to be swabbed.  If a bacterial infection is present, the patient can be given antibiotics by the pharmacist, without going to see their GP.

Describing general practice as the “jewel in the crown of the NHS”, Dr Nigel Watson, Chief Executive, Wessex Local Medical Committee and Independent Chair, GP Partnership Review, commented that general practice / primary care will be the most exciting place to work in the NHS in the next ten years.

Post Contributor: 

Caitríona Fitzsimons Digital Reporter