The Board received a presentation on Primary Care Networks (PCNs) and the vision for Primary Care.
It was noted that PCNs are formed from groups of practices covering 30-50,000 patients working together and will have an Accountable Clinical Director, 1 day per week per 50K patients pro rata and a Practice Management lead and a board made up of member practices with co-opted members from community service providers and other organisations
The aim of forming the Networks is to :-
· bring care closer to the community and focusing services around local communities and local GP practices to help rebuild and reconnect the primary healthcare team across the area they cover.
· improve health and save lives
· improve the quality of care for people with multiple morbidities
· help to make the NHS more sustainable
· Increase integration between practices, increase resilience, tackle variation in primary care, expand the primary care workforce, increase investment into primary care without it being siphoned off as profit.
The Board were informed of the steps taken in the formation of PCNs and the delivery of services and noted that as of July 2019 PCNs would be in operation offering extended hours across the network and recruitment to shared posts, initially social prescriber and pharmacist. PCN’s would then start working to deliver the network priorities.
The Board received information on the identified clinical priorities, funding model and network configuration and the new investment and impact fund which would be in place from 2020/21. In addition, proposed links with Gateshead H&CS and beyond and the below opportunities for joint working were also highlighted:-
· Joint training
· Mentoring for nurse /prescribers
· Expand frailty and complex younger patients support such as virtual ward/ network level MDT
· Development of intermediate care type posts
· Closer integration of practice and community nurse teams.
· Mental health - closer support for practices from locality teams
· Improved links with VCS and integration of practice into the community
· Developing alternatives to admission
· Improved access/alternatives to A+E assessment
· Developing alternatives to outpatient attendances
· Social Prescribing across Primary and Secondary care
· Palliative care - opportunity to move to best practice
· Named Consultant support for individual networks
It was commented that this presented an exciting opportunity in terms of the work done with Chris Bentley about planned care and emergency care.
It was queried whether deprivation was factored into the funding model and the Board was advised that the funding model was complex and one of the benefits of Primary Care Networks was having a collection of practices in deprived areas. It was noted that for some Primary Care Networks the demographics were different and so social prescribing may look at issues such as frailty eg in areas such as Whickham.
It was noted that a huge amount of work had taken place and the impact on patients was noted. The Board expressed delight at the use of Egberts House which is working with emerging networks.
A discussion took place around patient involvement and shaping services. It was noted that the CCG was keen that patients don’t have to travel too far for services but it was considered that there was a need to manage patient expectations in this regard.
It was commented that the rationale for the Birtley / Oxford Terrace Primary Care Networks was unclear.
It was queried how social prescribers would be identified and it was noted that a route for organisations could be “Our Gateshead” once this is refreshed.
It was queried how the Board could monitor and review how well this new system was working. It was indicated that this might be through the GP Federation feeding in audits and clinical governance monitoring reports but the way forward on this was yet to be agreed.
It was noted that ward councillors need to be kept up to date
(i) The Board noted the contents of the presentation.