PCNs could distract practices from core GP work, warns CQC chief inspector

Primary care networks (PCNs) could distract GPs from the core work that underpins delivery of high quality general practice, the CQC's chief inspector of primary care has warned.

Dr Rosie Benneyworth (Photo: Pete Hill)

Speaking in a Question Time-style debate at the RCGP annual conference, Dr Rosie Benneyworth said she was a 'fan of PCNs and the opportunities they will bring'.

But she warned: 'I do have concerns that PCNs will, or could be, a distraction from core work in general practices and from the fundamental basics that we need in good general practice.'

Dr Benneyworth, who took over her CQC role from Professor Steve Field in March, said that GP practice inspections showed strong leadership was 'vitally important'.

Clinical leadership

'If you don't have good leadership and good clinical leadership in particular then quality of care is not as good,' she said.

Debating a question about how GP career development could be supported within practices, she said that outstanding practices had good 'talent management programmes' that identified skills within their workforce and developed them to the full.

Chair of the RCGP First 5 committee Dr Jodie Blackadder-Weinstein said it was important that leadership was not seen exclusively as something that meant moving out of clinical work. She said: 'We need to be very careful that leadership, especially in the younger generation, is seen as a way of facilitating better clinical care, not as an exit strategy so you don’t provide clinical care.'

Somerset GP Dr Benneyworth responded: 'I completely agree. Leadership is not going off and doing management roles - that can be part of it – but leadership is how do you make change that improves the care that you give to people.

Developing care

'Leaders can be GPs, nurses, receptionists - anyone in your practices that can develop care for people.'

Responding to a question about how GPs could be supported to train emerging and expanding multidisciplinary teams and offer the supervision and support people in these wider teams need, Dr Benneyworth said this was a key issue for the regulator.

She said that 95% of GP practices were good or outstanding, but that among the small percentage that are inadequate a 'lack of supervision' was often a factor.

'One thing we see is a lack of supervision, and people working outside their competencies. With practices and PCNs it is fundamental to really consider how people are supported in these roles, and whether they are being asked to do things outside the range of skills they have. Supervision is really important for PCNs, as they develop, to consider.'

RCGP chair Professor Helen Stokes-Lampard said networks could provide support for practices to develop staff, pointing out that within small practice teams the skills and time to train all staff may not be available and that networks could be a 'better vehicle' for delivering this support.

'We need better career paths and training for everyone in our practices – I think we have taken our eye off the ball on that,' she said.

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