PCNs can transform GP workload by focusing on frequent attenders

Primary care networks (PCNs) can ease GP workload and improve access for patients through better management of 'frequent attenders', a healthcare policy expert has said.

Professor Becky Malby (Photo: Pete Hill)
Professor Becky Malby (Photo: Pete Hill)

Speaking at the RCGP annual conference, Professor in Health Systems Innovation Becky Malby said the current GP appointment system was ‘broken’, because it failed to direct patients to specific health professionals best suited to addressing their needs.

As a result, frequent attenders continue to eat into GP time and potentially prevent other patients, who present less regularly, from accessing appointments, she argued.

Professor Malby argued that PCNs, which are recruiting extra healthcare staff to support GP practices, presented practices with an opportunity to improve the flow of patients to the correct clinicians, freeing up GP time and decreasing frequent attender numbers.

GP caseload

She urged GPs to 'try and find out what is really going on in your caseload'. Professor Malby said: 'Firstly, what’s the GP work, and secondly what’s our caseload? What does it really look like, who is turning up and why?

'And what’s the best solution? Then design a solution, rather than just put in 10 minutes - because that 10 minutes isn’t working, they are still turning up and that’s [costing] a lot of money. We think you can start organising yourselves differently and better.'

Professor Malby revealed that around 40% of frequent attender patients presented to clinicians with ‘life problems’; something she said could be managed by staff such as social prescribers rather than GPs.

She warned this meant that some age groups were potentially missing out on appointments and that the system was not serving the whole population. ‘If you are telling me that seven to 24-year-olds don’t have health problems - I don’t think so. Under 24-year-olds definitely have health problems.

‘Some GPs have said that if they don’t come there is nothing I can do about it - but that isn’t good enough.’

PCN role

The healthcare policy expert urged PCNs not to get caught up doing work that should be left to CCGs and said they had to focus on improving patient care.

‘Don't even fall in the trap [of doing CCG work]. You should be looking at those frequent attender notes and reviewing them together. Even if you could solve one of these people’s problems over the year we would have done a good job together. We have to take a person-centred approach,' she said. 

Earlier this month, NHS England's medical director for primary care Dr Nikki Kanani warned that PCNs who prioritised CCG meetings over spending time with local practices and patients were 'getting it wrong'.

She said that PCNs had to be left to get on with developing relationships with local practices and bring about the changes they were created to deliver.

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