Top tips for managing PCN disputes
Even in successful PCNs, disputes can arise and can have a significant impact on constituent GP practices. The collaborative nature of PCNs means that it is important to try to avoid conflict, and to manage any disputes that do arise at the outset.
Common PCN problems
PCN disputes can occur for any number of reasons. Common issues that arise include financial matters, employment arrangements, contractual arrangements, and governance issues.
Additional issues can arise in relation to premises arrangements, for example in relation to sharing occupation, reimbursement, or property held by, or on behalf of, a PCN.
More recently, we've seen an increase in PCN disputes stemming from the expulsion of a practice, or the inclusion of an unwelcome practice at the insistence of the ICB.
We've also seen inappropriate escalation of PCN disputes to arbitration, leading to unnecessary legal costs being incurred.
How to manage PCN disputes
PCN disputes can be a huge drain on management time and a block to progressing the PCN's work.
There are some practical steps that GP practices in PCNs can take to try to avoid PCN disputes arising, and to help manage and resolve any disputes that do arise:
- Make sure that you have read your Network Agreement and ensure that it is properly drafted and updated to reflect any changes in the PCN - its not uncommon to open up the PCN agreement once a dispute arises, only to discover that many of the key schedules are empty.
- Consider your existing powers to expel a member and whether they are appropriate.
- If a dispute arises, read your Network Agreement at an early stage - it will help you understand your legal position and should set out mechanisms that can be used to help resolve a dispute.
- Keep accurate records of PCN meetings and any decision making, and be transparent about decisions made. We've seen cases where historic financial decisions have been scrutinised many years after events occurred.
- Instruct specialist accountants to prepare PCN accounts on an annual basis - not every PCN does so and it makes it very difficult to unpick finances when disputes arise.
- Try to keep channels of communication open to avoid taking entrenched positions.
- Seek additional assistance from third parties - LMCs are often able to provide advice and support (to parties on both sides of the dispute).
- Take early advice – involving solicitors in a dispute enables you to understand your legal position early on and can be helpful to avoid procedural errors in dispute resolution processes which may obstruct resolution of the dispute.
- Be mindful that, if matters escalate, you may be required to participate in a disclosure exercise, which may include disclosure of correspondence from personal email accounts, text messages and WhatsApp messages.
If a PCN dispute does arise, there are many ways it can be resolved - through negotiation, facilitated discussions, alternative dispute resolution (for example mediation and arbitration) and NHS Resolution or court proceedings. We regularly assist with resolving PCN disputes, and we take a pragmatic and commercial approach when providing advice.