FAQs

Q: Who is this website for?

A: This website provides a reference point to PCNs who are working to make sense of the deliverables being set and the needs of their population. It showcases some of our leading thinking on PCNs and our commitment to supporting them.

Q: What is the problem PCNs are the ‘solution’ too?

A: This is the core starting point. Defining the purpose of the PCNs is the essential of all future decisions. We believe that PCNs have an exciting role to play supporting their practices with the hardest challenges common to all their practices. the most complex patient groups and services .

Q: What is it that you do?

A: We help PCNs, and their supporting CCGs, to:

  • deliver on their service specifications,

  • improve relationships between members,

  • integrate (de-fragment) complex care.

Q: How do you help?

A: We help PCNs by looking at the root causes of PCN difficulties, rather the symptoms. We concentrate on the following core pillars:

  • Creating robust general practice - reliable, efficient and accessible care.

  • Managing complex needs - radical simplification and being clear on ‘purpose’.

  • Collaboration with communities - moving to seeing communities as assets rather than burden.

  • Developing primary care networks - learning the principles and skills of true network working.

Q: Why do you care so much about PCNs and primary care?

A: We believe PCNs offer a genuine opportunity to break the cycle of failed integration initiatives, colossal waste, overburdened clinicians and disjointed care for people at their most vulnerable.

The future more joined up, sustainable, innovative and patient focused NHS won’t come from those at the top, it will come from networks of clinicians closest to communities and those who live within them.

Q: When are networks a success?

A: Research shows this is when

  • There is clear shared purpose and identity

  • They are creative and innovative

  • They meet member needs

  • They are supported by adaptive leadership

  • They have strong relationships and ties within

  • They generate helpful outputs

Q: Why do networks so often fail?

A: Research shows us that any of the below will do it:

  • Failure to agree a common understanding of purpose and direction

  • Over-management and cementing relationships and structures that need to be dynamic and evolving

  • Over expectation of network member’s willingness or ability to collaborate

  • Prioritising some members over others

  • Constraining network member’s independence

  • Not recognising when leadership needs to change / rotate

  • Lack of impact in terms of network member’s purpose.

Q: As a CCG, how do I support PCNs?

A: PCNs are intended to help challenge the systemic barriers within our primary care systems. They do this by being small enough to engage with communities in an asset based way, but being large enough to make new models of care viable. As much of this is wrapped up in the new, invariably it means letting go of some of the old. For a CCG this means moving from a performance management starting point to a developmental one. This means not providing PCNs with solutions but with space and access to support so that truly locally derived and owned innovations and integration can be achieved.

Q: What is the dilemma that PCNs face?

A: The challenge is the gap between these two:

What the NHS experiences

  • Increasing complexity

  • Desire to create control and simple solutions

  • The need for certainty in an uncertain environment

  • Based on experience in leading in transactional cultures

What the NHS needs

  • Adaptive capability

  • Creative solutions

  • New capacity and resources

  • Experimentation

  • Requiring leadership through relational culture

Q: How do I improve relationships between our member practices?

A: Poor relationships are a symptom, rather than a cause. We believe you dont just ‘fix relationships’ but rather you invest in them. You can do this by putting time into defining the purpose of the network, how networks differ from other forms of collaboration (such as a federation) and also being very clear about what exactly you can only do as a network that you cannot do as an individual practice.

Q: How does working with you get funded?

A: This has varied by engagement. It has often been through CCG or federation funding. PCNs have funded work directly; and individual practies have funded work focused on themselves.
The win/win of the work in both care improvement terms and In terms of efficiency, resource and capacity savings make a powerful financial argument also.