The Winter Primary Care Network Update

With so much going on, it's hard to keep up. So here is our compilation of the latest winter guidance and mandates required of Primary Care Networks. This will be a good starting point for new PCN Managers and Clinical Directors.

As I write this, the Covid booster programme and core general practice services are the priority, but for many, there is still a focus on other primary care network developments, so this blog is for you.

1. Updates to the Impact and Investment Fund (IFF)

As communicated via NHS England on 7th December 2021:

• The three flu immunisation indicators and the appointment categorisation indicator (as the work is complete) will continue to operate based on the PCN performance in 2021/22.
• The remaining indicators will be suspended. ￡62.4m of the funding allocated to these suspended indicators will instead be administered to PCNs via a PCN support payment. This is to be paid on a weighted patient basis, subject to a simple confirmation from the PCN that it will be reinvested into services or the workforce.
• ￡49.7m will be allocated to a new binary IIF indicator. Funding allocation is based on all practices within a PCN being signed up to phase 3 of the COVID-19 Vaccination Enhanced Service as of 31st December 2021 and remaining signed up until 31st March 2022, and actively delivering the programme.
• The Impact and Investment Fund will recommence in full from April 2022.

I always get a little nervous communicating NHS guidance as it changes quickly. It can also be open to interpretation. However, the 4 points highlighted above are pretty clear.

The NHS letter can be found here and provides a full breakdown of the above summary.

2. Primary Care Network DES Update

On 1st October 2021, NHS England and Improvement revised their plans for 2021/22 and 2022/23. The documents can be found here. In summary:

• From October 2021, cardiovascular disease (CVD) prevention, diagnosis and tackling neighbourhood health inequalities will be introduced in a reduced or preparatory form.
• From October 2021, PCNs will be asked to work to identify and engage a population experiencing health inequalities within their area and co-design an intervention to address the unmet needs of this population. Delivery of this intervention will commence from March 2022.
• From October 2022, PCNs will deliver a single, combined, extended access offer funded through the Network Contract DES.
• Personalised care will be introduced in April 2022.
• By September 2022, PCNs will be required to agree on a plan for Anticipatory Care with their ICS and local partners.
• New funding has been released to support PCN leadership and management. This new funding is for clinical directors to recommend how it is deployed to create a new capacity to support the PCNs work.

The updated DES document, which was released on 20th December 2021, can be found here.

3. PCN Finances

As we approach the end of our financial year (March 2022), we will need to have a handle on our end of year PCN finances.

Check out my checklist below. As with all the guidance we provide, I recommend tailoring the checklist to your setting. Every network and manager will operate slightly differently.

In partnership with your financial lead;

1. Review finances ASAP to identify any underspent project funds and develop a plan of action to spend this money.
2. Assign a cut-off date to ensure costs that the network incurred before the year ends is assigned to the correct financial year.
3. Ensure all invoices are raised for work carried out this year.
4. Ensure bank reconciliations are up-to-date and aligned to bookkeeping entries. This includes ensuring bookkeeping codes are consistent and descriptions of bills and services are accurate and thorough.
5. Review all subscriptions and check whether you are still fully utilising these services.
6. Book an end-of-year meeting with your accountant and your PCN Board to help you financially plan for the year ahead and understand your position over the past year better, as well as discuss any tax implications.
7. Ensure all tax return information is correct, signed and submitted.
8. Archive any information and make sure this is clearly organised and labelled.

If you are in doubt, please seek advice from your accountant.

4. End of year Project and Service Reviews

In partnership with the managers and clinical leads, organise an end-of-year project, service and contract reviews to explore:

• What was achieved?
• What worked well?
• Areas for development
• Activities that should stop

If you have contracts that are up for renewal or want to engage in a new endeavour, please check out our Questions to Inform your Next Primary Care Partnership, which can be found here.

5. Annual Performance Reviews

I know you already meet with your PCN teams informally, but if it has been some time since you has a formal, documented meeting, I would suggest this happens in Q4. These questions could form part of your agenda/discussions:

• What progress has been made on previously set objectives?
• What is working well?
• Have they received any positive feedback to affirm their work?
• Do they have any professional development needs?
• What support do they need from you?

It's important to address any potential issues, praise efforts, put learning and development plans in place and keep lines of communication open.

6. Business as usual

National priorities that PCNs are already delivering on:

• Structured medication reviews (SMRs)
• Social Prescribing
• The vaccination programme
• Enhanced care in care homes
• Early Cancer Diagnosis
• Recruiting using the Additional Role Reimbursement Scheme (ARRS)
• Extended Access
• Monitoring network performance

Local contracts and projects PCN are also delivering on:

• Local development plans
• Practice Incentives Program (PIP)
• Local Incentive Schemes (LIS)
• Enhanced Services (ES)

Again, every network is different. For example, your PCN Pharmacists may move from delivering SMRs to vaccinations, but this should give you a sense of the work that may be carrying on in your network.

Speak with your PCN leadership teams, for contract and commissioning advice. My first port of call would be your Head of Primary Care Transformation (or a similar title within your CCG).

If you’re new to your PCN Manager role or a CD who has hired a PCN Manager over the last year, registration remains open for Cohort 3 for the PCN Managers Programme which commences on 10th January 2022. Places are now limited so please register or arrange a discussion as soon as possible if you’re interested.

If you liked this blog, you will also find the following articles valuable:

The Role of the PCN Manager

The Role of the Clinical Lead

What are you Tolerating in your Primary Care Network?

How to Overcome Objections in your Primary Care Network

Tara provides project and network management to Primary Care Networks, training and mentorship to the PCN Managers and Clinical Directors and has worked with 11 Training Hubs and 18 Primary Care Networks to date.

Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs and also hosts the Business of Healthcare Podcast.

Do connect with me on LinkedIn or follow me to see my articles in your LinkedIn news feed.

• Practical Top Tips & Guidance
• PCN Manager Bundle