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Primary Care Networks (PCNs) FAQs

How will a practice be funded for signing up to the DES?

Each practice will be entitled to an annual weighted payment of £1.76 per patient

Who can be the Clinical Director of a PCN?

It is expected that this will be a GP from the area that the PCN covers and could potentially be a locum, salaried GP or partner

What funding exists for the PCN Clinical Director?

Equivalent of 0.25 WTE will be funded per 50,000 patients (or one day per 40,000 patients) which is the funding contribution, not the expected commitment of the role which may exceed one day per week (to be determined by the PCN)

How does a PCN decide who its Clinical Director should be?

This is for the PCN members to decide. It may be via election, shortlisting then interview etc.

How will the PCN make decisions?

This is to be determined by the network (e.g. majority vote, CD discretion, unanimity) – the number of votes or weighting for each practice may be determined by the network (e.g. it could be based on respective practice list size, or by staff numbers, or one vote per practice)

What else will the PCNs get as benefits?

There will be funding for additional roles to help to supplement the PCN member practices and provide extra resource. Contributions will be made at 70% for a Clinical Pharmacist, Physician Associate, First Contact Physiotherapist, First Contact Paramedics and 100% for the Social Prescriber

What other funding is available to the PCN?

£1.50 per patient must be utilised from CCG allocations

What will we have to do as a PCN in 2019/20?

A clear requirement is that the network must agree how they will deliver the requirements of the Extended Hours DES for the whole of the network population (may be devolved back to individual practices, or other arrangements agreed). £1.45 per patient funding for Extended Hours.

What else will we be signing up to do?

2020 - Structured medication review, Enhanced health in care homes, Anticipatory care (with community services), Personalised care, Supporting early cancer diagnosis.

2021 - Cardiovascular disease prevention and diagnosis through case finding, Action to tackle inequalities.

It is possible that locally commissioned services will eventually see funding transfer to the PCNs (subject to local negotiation with LMC/practices)

This new workforce and new funding, how will the PCN utilise them?

Network to agree how the new workforce is employed (by practices, a lead practice, a federation or community trust on behalf of the network etc). The PCN to agree how the workforce is deployed, in line with agreeing how services are configured

What kind of things will a PCN need to decide?

A ‘Network Agreement’ will need to outline what decisions the network has made about:

  • how they will work together

  • which practice will deliver what (for specific packages of care)

  • how funding will be allocated between practices (if appropriate)

  • how the new workforce will be shared (including who will employ them)

  • any other agreements made between the practices (eg pooling of practice funding etc)

  • The agreement may be updated year on year as new services, workforce and funding comes online

  • A template agreement, and guidance, is currently under development and will be published in March, alongside the DES specification

What future development options exist for the PCNs and its workforce?

NHSE will be establishing a ‘significant’ support programme for PCNs and well as for CDs. 

Can a PCN make a loss, become insolvent or borrow money?

This is an extension of the practice contract, so just as practices operate within a defined budget, that's the same for the wider PCN.

Who is responsible for any debt a PCN develops?

It is the responsibility of the practices within the PCN.

Can a PCN make a profit, and if so can a PCN distribute profits to its Members?

Again, this is the same as for practices and for the members of the PCN how it uses its funding.

Can a PCN close/merge/split, and if so, what happens to the PCN's assets/liabilities?

Yes, and this will be dependent on the network agreement.

If a Core Member wishes to leave it needs to notify the commissioner of its decision and consent will not be "unreasonably withheld", but if this takes a PCN significantly below the population floor is this adequate reason for a CCG to refuse?

This is the similar to forming PCNs, the CCG's role is to ensure there are no gaps or patients left out and that PCNs are of sufficient size to ensure viability. A practice won't be prevented from leaving a PCN and ending their role in this activity, but if that leads to the remaining PCN it will lead to the CCG, working with the LMC, to consider the best way forward for the area.

If a large Core Member (eg > half the numbers) leaves but the patients stay, will the smaller Members continue to have to deliver all the services across the whole PCN's patients (eg Extended Access)?

Again this might lead to a wider discussion in the area between remaining PCNs, the CCG and LMC. One option may be for the smaller practices joining with a neighbour but its for the local area to consider the best options.

If a Core Member leaves and the funding is reduced such that it is no longer possible to employ a similar number of staff, who pays the redundancy?

The network agreement should make it clear.

If there are Employment Law findings against a PCN who pays the penalty?

This will relate to the employer, as agreed within the PCN. Again the network agreement needs to be clear on employment issues.

If there are extended periods of employee leave (eg Maternity/ Sickness) is backfill funding available to a PCN or do Members simply have to cover the workload?

Again, this is up to the practices to determine within the network agreement and is similar to how they manage practice staff leave.

At the end of the 5 year term of the DES what happens to staff employed under the DES?

The intention is to continue the funding commitments as intended for other areas of national funding within the contract.

 

Updated on 02 April 2019, 811 views

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