This means that primary care contractors can now move to progress the development of their Primary Care Network (PCN) governance arrangements into a more formal footing in readiness to register their PCN by the deadline of 15 May 2019.
Our recent input to the Family Doctor Association PCN Factsheet highlighted the steps that could be taken by contractors while waiting for the documentation and much of this is still relevant. Identifying your PCN's objectives and delivery model will then enable the PCN to evaluate this against the main concerns noted below.
There is no doubt the PCN itself is underpinned by a contractual collaboration, as opposed to a corporate entity but as with MCPs and PACs, the delivery model may differ between localities and the mantra of "form follows function" remains as pertinent as ever. PCNs can include corporate primary medical service providers as members and looking outside the Network Agreement itself, we might expect to see a range of other providers and stakeholders working with PCNs under separate contractual arrangements to fulfil the local delivery model. This may include setting up new corporate structures.
It should be noted that 2019/20 is the first year for PCNs and it is expected to evolve over the coming years to take on additional services and potentially incorporate non-primary care contractors. It will be important to keep abreast of the changes and ensure that the arrangements are adapted and kept up to date as these changes are brought through.
The Network Agreement sets out the core elements of the collaboration between the parties as well as the minimum collaboration requirements that NHS England require in delivering the Network Contract DES. Whilst it deals with important general collaboration issues such as leaving and joining a PCN as well as other standard contractual provisions, it is structured as a template and the bulk of the detail of the arrangement is to be populated by practices within the schedules provided. These include but are not limited to:
Consequently, the Network Agreement can be adapted to reflect the particular delivery model of each PCN.
Inevitably, when sharing services and staff, the mains concerns will be around the availability of the NHS pension scheme and potential VAT issues, but these are not the only areas which require careful thought. There are a range of other considerations including: sharing data, subcontracting, apportioning liability and documenting any premises solution.
We work closely with specialist medical accountants and PCN support services to help fledgling PCNs develop their model and their governance arrangements as well as with continuing support. We provide a service tailored to the needs and current progression of your PCN and are offering PCN development workshops to assist practices to develop their model.