Where To Start – dilemnas of a PCN CD
I’ve been lurking on Whats App groups and meeting with PCNs during their rushed and short meetings. I can see the intent of PCNs getting lost in the bureaucracy of how to be paid for pharmacists, how to manage VAT….. the idea that PCNs will be real networks of collaboration with the ability to solve problems that need them to work together is getting saturated by ‘stuff’ as the old world bite back. It’s getting to the point where the start up noise is drowning out the real long term point of PCNs
If PCNs carry on getting bogged down with the transactional, contractual ‘stuff’ they will have nothing left for the real work, and nobody to do that work with.
There is no doubt that some of the architects of PCNs totally get it – their intent is about changing the model of care – the way we meet needs together. So here are some top tips for CD leaders for the coming months:
Prioritise Purpose. Do the things that really matter to your community, you and your collaborating practices.
That means – Discover Needs. Work with your partner practices to find out whose needs are not being met by the current system of delivery. Your practice nurses, receptionists and GPs will have a good hunch, so follow you noses and see what you can find out.
Meet those Needs – work together to solve these complex people’s problems.
Create a legitimate space. Do enough of the ‘stuff’ to make sure you have the air cover to do the real work, and get help for the ‘stuff’ from those that do it well. There are plenty of people working in local NHS organisations who know how to project manage the life out of the NHS, use them for the transactional work.
Make your own luck – involve anyone in the creation of your network that could help, and who is committed to your purpose. Local councillors, community leaders, other services.
That reminds me – you do need to be clear about your purpose in a way that your community can understand it, and will back it because it’s clearly adding value….
Work out who you are accountable too. You are using and spending public money, who do you think can say yes or no to how you do that? Who do you want to be your ‘owners’. There is real power in making that your community rather than the NHS hierarchy.
Develop a membership model that ensures you can have all the benefits of a network – creative solutions, diverse views, peer based collaboration, real impact; that means equality, and a clear view about what being a member means in terms of obligations (joining in ) and expectations (clarity of purpose ), and how you will handle those that don’t pull their weight and those that are over enthusiasts! Predicating a core group of ‘doers and enthusiasts’ also predicts network failure (Malby and Anderson Wallace 2018) its all together or not at all….