PCNs struggling to resist CCG pressure to shape their priorities

Primary care networks (PCNs) are struggling to resist pressure from CCGs seeking to influence their priorities, clinical directors have warned - as the BMA's top GP urged them to seek support from LMCs.

GPC chair Dr Richard Vautrey (Photo: Pete Hill)
GPC chair Dr Richard Vautrey (Photo: Pete Hill)

During a session on the progress of PCNs at the RCGP annual conference in Liverpool Dr Sian Stanley, a PCN clinical director in Hertfordshire, said that CCGs in her area ‘had got the wrong end of the stick’ and were looking at local priorities in a ‘totally different way’ to network leaders. She said PCN leaders had interpreted information from NHS England and the BMA differently to the CCG.

This had left her taking on work that she didn't understand, leaving her suffering from 'sleepless nights', she told the conference. Dr Stanley said: 'There has been a disconnect between the BMA message in terms of a contract enhancement and the NHS England message which seems to be more complex, particularly when it came to CCGs.

'CCGs seem to be seeing this very differently to the way that it was meant to be perceived and, from that perspective, their focus is very much on the maturity matrix, asking where we are we up to and if we are future-proofing ourselves and where we will sit in the integrated care system (ICS) and the integrated care provider (ICP).

PCN workload

'Where there was this great potential I feel, already, incredibly bogged down in what are political things that I don’t really get.’

GPonline recently reported that some PCN leaders were feeling ‘overwhelmed’ and needed support in order to avoid burnout. Locum GP and clinical director of Bridlington PCN in Yorkshire Dr Zoe Norris warned last month that clinical directors would walk away from the job if they were not adequately supported to manage their workloads.

Speaking at the RCGP annual conference, clinical director of Derbyshire Dales PCN Dr Ben Milton echoed concerns that CCGs were moving in different directions to PCNs leaders. He said his PCN was feeling pressure to focus on financial priorities driven by his CCG.

BMA GP committee chair Dr Richard Vautrey told delegates it would be wrong to expect PCNs ‘to solve the world’s problems’, but said they should be closely involved in conversations to improve primary care.

Practice teams

‘Just because we have groups of practices working together in sensible teams, we cannot expect that the poor clinical director and the people who are working alongside them to step up and deliver all of these issues by tomorrow,' Dr Vautrey said.

‘We need to be involved in these discussions, but we cannot solve things and we cannot overburden people, we need to protect our clinical directors particularly at the moment so that they are working within their expectations and they are not finding themselves overwhelmed.'

Dr Vautrey added that CCGs and ICSs had been given funding to support leadership development within PCNs. He said it was up to PCNs to work with their LMCs in order to ensure this funding was put to good use.

He also urged clinical directors to use their LMC to 'say no to work'. '[LMC's can help to] provide some resilience for PCNs... so when you are being asked to do things that are unreasonable and beyond the funding and resource that you’ve got to be able to deal with it.’

More from the RCGP annual conference

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