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15 January 2020

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Our primary care network (PCN) is struggling to manage from the money we have been allocated. How can we make the most from our funding?

Our panel of experts tackle the challenges that take up your time. Compiled by Kaye McIntosh

Daniel Vincent

Sadly, I am not surprised to hear this. PCN direct funding can only really be considered seed funding at £1.50 per patient. Our CCG, for example, spends £20.34 per patient to deliver the commissioning of services.

This seed funding will need to be used to create a structure that is ready and able to receive funding through other streams. Your CCG should have made £3 per patient available to practices under the transformation funds – these initiatives must be delivered at scale, ie through a PCN.

As 2020 approaches, we should have further details on the additional funding available to support the seven services outlined in the DES.

Spending money with the voluntary and community sector could maximise your funding. We have found our colleagues there to be extremely efficient, innovative and great at finding match or top up funding.

Daniel Vincent is managing partner at Ryalls Park Medical Centre, Yeovil, Somerset

Steve Williams

The first thing that you need to understand is the current level of sustainability of your PCN’s member practices. If you analyse the average funding per patient of each practice, it is likely that they will not be the same. Drill down further and you will probably see that there are areas where one practice is achieving a higher return than another. Do you understand how they can achieve this higher income ratio? The chances are that your practice will also be performing better in certain areas. QOF income is a clear example, but it applies to all enhanced services income.

Understanding what you can do to improve current earnings is a start. Next, you need to look at the new income streams that will become a possibility as a PCN. Financial certainty for the whole group will be a positive driving factor. Identify any risks early and help the group to make an informed decision about how best to maximise potential income streams.

Use all the available information. Speak to each other and share data. Invest some time to analyse the financial health of your PCN – immediately. If you would prefer to make a small investment so that you can use your valuable staff time elsewhere, then Management in Practice’s sister website Pulse Intelligence will give you a lot of the financial information needed to allow your PCN to grow. There is scope for improvement – you just need to identify where the marginal gains can be made, take action and see the benefits.

Steve Williams is co-chair of the Practice Management Network

Nick Nurden

It is taking some time to establish exactly what the ask from PCNs is and this is being interpreted in different ways by different networks. Some are far more involved and active than others. Some are starting to do things centrally for the whole PCN more quickly than others that may simply be coordinating work that is mainly still being done at an individual practice level.

It is important that the PCN doesn’t overstretch financially and that it is realistic about what can be achieved with the DES money. This is especially important when one practice or a few individuals are shouldering the burden of PCN work – it is essential that the whole thing is sustainable to avoid practices falling out with each other. Between us we need to make them work.

Having identified what the essential deliverables are as a group you need to prioritise. Which are essential – needed to tick a box nationally as a DES requirement, for example. Which are less urgent? Which are the “nice to dos” that are not mandatory?

Work out how much resource is needed to deliver each of the tasks. Start allocating the resource that you have to the essentials and keep going till the resource runs out. That is where you need to stop – we can only do what we have the capacity to do and should not feel bad about only doing that much. Keep that list under review and re-prioritise as things develop and keep sharing and agreeing this across all the practices in your PCN.

Nick Nurden is Business Manager at The Ridge practice Bradford, West Yorkshire