I have to admit I emerged from BMA House on 5 June on a bit of a high – more enthusiastic and energised than I had been before. I had just attended a one-day event, organised by the BMA in collaboration with the General Practice Defence Fund (GPDF) and NHS England, aimed at the clinical directors of the nascent primary care networks (PCNs) across England.
Up to this point I had felt quite daunted at the prospect of what lies ahead, having spent the previous few weeks grappling with network agreements, VAT issues and how to get everything done by 1 July, all on top of the busy day job. But the conference was an opportunity to look beyond these issues and see the potential in this new contract, as well as meet and share experiences with fellow clinical directors from around the country.
Whichever angle you look at it from, few can doubt the ambition of NHS England’s policymakers. Your mission, should you choose to accept it, is to form a network of practices, find a willing leader from within to become clinical director, create a written agreement that sets out your structure and decision making that all members support, and then advertise, appoint and employ two completely new members of staff. All by the end of June.
Driving passed the Glastonbury Festival site on my commute to Grove House Surgery in Shepton Mallet where I’m a GP partner, I’ve been fascinated to see how organisers prepare for one of the biggest music festivals in the world. I often reflect on whether GPs have a comparatively monumental task ahead, but without the benefit of any prior experience or an army of helpers.
There is a case to be optimistic, though. GPC chair Dr Richard Vautrey told the conference than the very fact that GPs have risen to the challenge and already formed PCNs around the country in such a short timescale demonstrates to the wider system and the country what general practice is capable of. We should be proud of that. I certainly am.
One of the main positives for me has been the collective goodwill emerging from all corners, both nationally and locally. The very presence of leading figures from the BMA, GPDF and NHS England at the clinical directors’ conference and the fact the event, which was packed with useful content and optional one-on-one career coaching, was organised and delivered without any fee for the participating clinical directors, demonstrates the commitment of these organisations to making PCNs a success.
Making general practice sustainable
At a local level in Somerset I feel fortunate that, with the support of a superb LMC, we have developed a sense of comradery and mutual support among the PCN clinical directors. We have social events and active WhatsApp and Slack groups where we’re sharing ideas and challenges, as well as a monthly leadership training programme with the Wellbeing Collective, which has been funded by our CCG.
The new contract is an opportunity for small and isolated primary care teams to start working together to tackle common problems we’ve previously faced alone. With a new collective voice, we will be able to make a stronger case to our CCG or secondary care teams for tailored services that our patients need.
The Additional Roles Reimbursement Scheme – the extra funding that will pay for new roles in primary care over the next five years – will enable us to build a workforce that not only supports our existing teams but allows us develop new innovative ways of working.
In my area this might mean our new network community pharmacist can visit our many frail, elderly patients who are at high risk of falls, spending quality time reviewing medications and reducing poly-pharmacy, freeing up the GPs to concentrate on other equally important work elsewhere in the system.
Innovations like these are the only way we can make primary care more sustainable for the future. The fact that each PCN has flexibility within the contract to come up with and implement their own ideas, rather than top-down changes, means this is an exciting opportunity to make a real and long lasting difference to our patients – and our own working lives.
There are certainly big challenges ahead, but I feel strongly that working through these challenges together is an opportunity to forge stronger relationships within my network, which in turn will help make us a more effective and cohesive ‘team of teams’ going forward.
- Dr Weaver is a GP in Shepton Mallet, Somerset and clinical director of Mendip Primary Care Network