Average PCN could be 14% larger than anticipated, NHS figures suggest

Early data from primary care networks (PCNs) suggest they could be at least 14% larger on average than NHS England's proposed standard size of up to 50,000 patients.

PCNs larger than expected (Photo: SOPA Images/Getty Images)
PCNs larger than expected (Photo: SOPA Images/Getty Images)

The five-year GP contract, published earlier this year, says PCNs should cover a population of ‘typically’ 30,000 to 50,000 patients. However, deputy national medical director of primary care for NHS England Dr Raj Patel has suggested that the actual size of PCNs across the country could be considerably larger.

Practices were asked to submit network proposals to their CCG by 15 May, giving an indication of what PCNs might look like once the registration process is complete on 30 June.

‘By the end of June we’ll know how many PCNs there are,’ Dr Patel told a Westminster Health Forum event this week, adding: ‘We think [there are] going to be around 1,000 to 1,050.’

Primary care networks

The latest NHS data on the number of patients registered with GP practices in England shows that there are 59,800,000. Averaged across the anticipated 1,050 PCNs, this equates to almost 57,000 patients per network - 14% more than the upper end of the 30,000-50,000 suggested range.

However, Dr Patel admitted that there was likely to be significant variation in network size across the country. ‘Where there are networks that do make sense at a much larger scale we’re saying that’s OK,’ he said, adding that some networks were ‘emerging at over 100,000’ patients.

Comparatively, the ‘smallest’ networks could have a population of around 26,000 patients - roughly 13% below the 30,000 minimum for a 'typical' PCN.

Variation

Network proposals that have been made available by CCGs across the country do indeed suggest that PCNs will be hugely varied in terms of size and shape. For example, Greater Huddersfield CCG has received proposals from five networks - four of which have a list size of more than 50,000 patients.

In Portsmouth, the smallest network proposal falls below the 30,000 mark at just 28,000 - while the locality’s largest network covers 80,000 patients. The same is true in Bury, where network proposals range from 29,700 to almost 70,000.

Meanwhile, BMA leaders are set to challenge plans for Babylon GP at Hand to form a standalone primary care network of over 50,000 patients after Hammersmith and Fulham CCG said the move was 'likely to be endorsed’.

If approved, the GP at Hand network population would be 'dispersed over a significantly larger geographic area than other PCNs' - an arrangement which GPC chair Richard Vautrey described at the time as 'flying in the face of both the NHS long-term plan and the national GP contract agreement'.

'Raring to go'

Dr Patel said NHS England had been keen to ‘stand back’ and ‘allow PCNs to grow organically’ so that they can ‘respond to the needs of the individual communities they serve’.

Also speaking at the Westminster Health Forum event, Dr Vautrey said that GPs involved with the formation of PCNs were ‘ready and raring to go’.

He said: ‘[The PCN model] enables practices to work together, it will enable them to learn from one another, share with one another… It will enable a coordination of what currently is a very fragmented service in various parts of the country. So it provides an opportunity to bring things together and for the practices to lead on that. But also crucially it rebuilds the community team with the practice.’

Every practice within a proposed PCN has until the end of the month to sign the network agreement. NHS England has previously confirmed that core PCN funding of £1.50 per registered patient will commence from 1 July and ‘should be backdated’ to 1 April 2019.

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