16 / 01 / 2020
While the specifications are clearly well-intentioned and represent the right direction of travel, there are currently a number of issues which warrant further refinement. The service specifications must avoid overloading Primary Care Networks (PCNs) or destabilising trusts and other partners, instead focussing on developing local partnerships and supporting existing good practice. More clarity is necessary on how funding flows will function, and on some of the practical detail-for example, if the DES is voluntary, what would happen in a neighbourhood if the PCN or a number of its practices chose to reject it?
During the webinars that informed the engagement process there has been ongoing confusion about whether the purpose of PCNs is primarily to stabilise and support the primary care system, or whether it is more focussed on bringing primary care providers together with the full range of local partners to deliver integrated care to local communities. It would be helpful if NHS England and Improvement were to articulate the relative weighting of these twin objectives clearly and consistently, reminding local partners that they are expected to meet both (if indeed this is the case).
For example, the draft service specifications document states that the establishment of PCNs will improve links between providers of primary and community services 'so that general practice feels much more connected and supported by the wider NHS system.' We would suggest that PCNs should aspire to create an environment where all providers in a neighbourhood- whether primary, community, mental health or other - feel equally supported by the wider NHS system.
Click the link to read the Community Network's full response.