Just over a quarter of PCNs – 27% – have formed a company, according to a survey.
Conducted by our sister title Pulse PCN, the survey also found that out of the 60% that had not formed a company, five said they were either in the process of forming a company or that they were planning to do so.
Another said they felt they ‘may need to do this’, and a further two said they had a federation that supports the PCN and operates as a company.
A total of 228 PCN representatives responded to the survey, carried out between September and October.
Dr Ben Gowland, director and principle consultant at think tank Ockham Healthcare, said that more and more PCNs are forming companies because of issues around staff.
‘The primary driver for this is the employment liability of the ARRS staff. As the numbers of staff have increased the liabilities have become greater, and for PCNs where the employment is held by a single practice it has become too much for them to be comfortable to hold,’ he said.
‘The company structure means that the practices are no longer directly liable.’
He added that the main downside of this model was the ‘loss of flexibility’.
‘We do not know what will happen with PCNs even next year, and it may harder for those with a company structure to flex to meet the new requirements (whatever they are!),’ he said.
‘PCNs incur legal costs in establishing a legal structure and then will have to pay out even more to make any further changes that are required.’
Another drawback of incorporation, Dr Gowland added, is that it reinforces the perception that a PCN is ‘somehow separate’ to practices, rather than an extension of them.
‘This can exacerbate tension where it occurs between the practices and the PCN,’ he said.
There are currently 209 companies registered as active on Companies House that have PCN or primary care network in their name and whose nature of business is general medical practice activities (see map below).
Ruth Rankine, director of the NHS Confederation’s Primary Care Network, said it isn’t ‘surprising’ so many PCNs have become companies given that many ‘have been working collaboratively at scale for up to six years’ and needed to ‘develop an infrastructure to deliver the broad scope of the directed enhanced Service (DES)’.
‘Incorporation can also help support in several other areas such as employment, resilience, and, in some cases, innovation of clinical pathways for local services,’ she added.
‘Some PCNs have created alliances with each other and with their federations to create GP organisations to work at scale as GP provider collaboratives for advocacy, influence, and services.’
Ms Rankine also warned: ‘Incorporation can promote resilience in general practice and provide mutual aid for struggling practices. But it should be done with good legal advice, clear decision making and governance, variation and risk support.’
The survey was carried out by our sister title Pulse and was open between 19 September and 18 October 2024, collating responses using the SurveyMonkey tool. After removing duplicate entries from the same primary care network, a total of 228 PCN representatives from England responded to these questions. The survey was advertised to our readers via our website and email newsletter, with a prize draw for a £200 John Lewis voucher as an incentive to complete the survey. The survey was unweighted, and we do not claim this to be scientific – only a snapshot of the PCN population.
This article was first published by Pulse PCN
