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Aspects of practice management could be undertaken by PCNs to create capacity, Government told

by Jess Hacker
14 January 2022

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Some aspects of the management and business functions of general practice could be undertaken ‘at scale’ at PCN level, rather than individually by practices, the NHS Confederation has suggested.

In evidence submitted to the Government’s consultation on the future of general practice, the organisation said that some HR, finance, and estates tasks could be done outside of practices to lighten the administrative burden.

Published yesterday (13 January), it cited as an example the introduction of the Additional Roles Reimbursement Scheme (ARRS), which has seen employment managed at PCN level or by the GP Federation.

Similarly, some GP Federations deliver a ‘complete back-office function’ to their PCNs.

The submission said: ‘This can create capacity in general practice by freeing them from administrative and bureaucratic burdens’.

It also warned that practices may lose many existing support functions currently provided by CCGs, with their replacement Integrated Care Boards (ICBs) gaining statutory footing in July.

The consultation – which was launched in November and closed submissions in December – will examine the key challenges facing general practice over the next five years.

It will focus on specific issues including regional variation, workload, and general practice’s partnership model.

Practice managers ‘undervalued’ by NHS

Practice managers are ‘often undervalued or unrecognised by the wider NHS’, evidence submitted by the Practice Management Network (PMN) claimed.

They operate as the ‘single point of access to the GP practice’ and ‘the organisational continuity’ within a PCN, and are under ‘increasing pressure’ to deliver complex services, it argued.

The PMN also suggested that greater numbers of managers are becoming partners without the benefit of the New to Partnership Payment Scheme.

It said the practice manager role needs strengthening, requiring:

  • NHS England to improve partnership working with practice manager groups, and involve them in strategy
  • Investment in practice management training and career development
  • Formal acknowledgement for practice managers as lead partners and partners
  • Stronger voice for practice managers within PCNs.

Contact the practice, not the GP

Further evidence submitted suggested that Government and NHSE messaging that directs patients to ‘contact your GP’ rather than the surgery is ‘problematic’.

Ann Spooner, a practice manager at Stockbridge Surgery, said: ‘We have to be able to direct patients to the most appropriate service – but if that service can’t cope or meet the expectations of patients then they return to general practice.’

She highlighted that NHS 111, nurses, carers and community pharmacists may direct patients to contact their GPs, often with timeframes attached.

Data published last month estimated that 34.6 million appointments took place in practices in November, of which 4.1 million were Covid vaccinations delivered by a practice or PCN.