Dr Mark Sanford-Wood: Primary care networks offer GPs a chance to take the reins of the NHS

GPs are naturally wary of primary care networks after years of being frozen out of NHS planning, says BMA GP committee deputy chair Dr Mark Sanford-Wood - but getting involved offers a once-in-a-generation chance to develop an NHS built around community-based care.

Dr Mark Sanford Wood (Photo: Wilde Fry)
Dr Mark Sanford Wood (Photo: Wilde Fry)

For years now GPs have been forced to sit on the sidelines and watch others decide the direction, future and fate of our local health structures. At times it has been difficult to watch those in control of policy demonstrate such woeful ignorance of the realities of general practice or the practicalities of delivering ever more complex care in community settings.

With the dawn of primary care networks (PCNs) a step change in leadership and control is taking place before our eyes. For the first time in a generation policy-makers and commissioners are beginning to beat a path to our door.

Clinical directors, scarcely in post, are finding their inboxes increasingly full of traffic from those hoping to engage with PCNs. There is even talk of integrated care systems (ICSs) becoming increasingly led by GPs.

Community-based care

This sudden increase in attention feels strange to a sector that has traditionally been sidelined, and this change in tone has generated some natural suspicion within our ranks. Yet this is the opportunity for general practice to take the reins and drive policy in a direction more conducive to properly resourced community-based care.

There are some who fear the move towards PCNs is a dynamic that will undermine the independent contractor status of practices and even presage their imminent privatisation. What seems clear to the hundreds of GPs that have stepped forwards to take up roles as clinical directors is that the opportunity to influence, direct and control the evolution of local health economies has arrived.

Of course that brings with it responsibilities that just a couple of years ago seemed unlikely. The argument for greater GP involvement in local leadership has been won, and the prospect appears to be enthusing a new generation of potential leaders along with the experienced cadre of existing shapers.

Primary care networks

The system must now support the development of this new influx of talent. There is a challenging programme of work ahead of us as PCNs settle into their forms and begin delivering their functions, and the learning curve for many will be steep.

Our colleagues taking up this mantle will need our help and we must nurture their growth. At times that will mean protecting them from other parts of the system that will be only too ready to leave their problems at our door and there will be a tension between this need to protect and the need for PCNs to step to the fore.

National bodies are busy offering this support to clinical directors and it is vital that these efforts are co-ordinated to provide them with the safe environment they need to fulfil their potential.

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