GP federations have a strong history of supporting practices to provide them with the representation, operational support and skillsets that are difficult to deliver as individual organisations.
The establishment of PCNs brings together GP practices to operate in collaboration, with the potential to provide many of the roles or functions that previously sat with federations. To prosper under the new Primary Care model, Federations will need to have a new market offer to individual practices and PCNs
We’ve had the chance to work with federations and speak to individual PCNs to get a better sense of what the changes in expectations are. Here is a list of our top opportunities for federations to provide a meaningful and cost-effective service for primary care in their area.
- Providing the skillset and management for overseeing PCN development
Over the next few months, PCNs will be expected to conduct set-up activities including:
- Organising themselves into a functioning unit with clear leadership
- Analysing the health needs of their combined population
- Recruiting and onboarding new roles and positions and integrate them into the PCN
- Reviewing pathways and developing new services
- Procuring and integrating digital technologies into their practices
Managing these processes, as well as several other tasks, will require a strong project management skills and capacity to drive progress. While each PCN could hire its own a project manager/PMO team, a more effective route could be for the federation to hold a shared PMO team works across multiple PCNs, making use of the similarities in requirements and cross-pollinating learning to improve the process
- Developing Quality Improvement expertise
One of the big takeaways from the Long Term Plan was the ambition to build in strong QI practices within PCNs to continuously improve the care and services provided to residents. Federations can support PCNs improve this capability at two points: hosting expertise that can work with PCNs to develop a better QI mindset and structure by providing the training and framework to make it work, and by facilitating continuous checkpoints to ensure that improvement activities are facilitated by a recognised QI expert. This expertise would be shared and circulate regularly across a number of PCNs, making it a cost effective, and useful, proposition for support.
- Managing traditional back office functions over multiple PCNs
As new organisations, PCNs will need to establish many of the same back office functions a large organisation would. However, the scale of PCNs means that having a full back-office may not make financial sense. A federation can support a group of PCNs by holding many of the back office functions, and sharing the resource on both an continuous and on an as-needed basis for activities including:
- HR and recruitment support
- Legal advice
- Financial advice
- Maintaining IT and a shared database that can be accesed by each PCN
- Procure PCN services on an adhoc basis for individual PCNs
While the points above speak to what federations can do to support a group of PCNs, making use of efficiencies of scale, there are many things that an individual PCN will want to do itself. However, finding and commissioning the right support to help with their ambition will take time and expertise- which may not be readily available. A federation can hold a ‘procurement’ function, understanding the needs and requirements of the PCN and sourcing the right support either through a set of preferred suppliers or by holding a competitive tender, taking the task off the hands of the PCN.
Of course, there are a number of configurations a federation can take to supply this and not all areas will have the same requirements for their federations. However, we think this is a good place to start the conversation between PCNs and federations and one that will allow the best usage of the extra money that is being pushed into primary care to make real and effective change on the ground.
If you’d like to learn more about the work we’ve done or where we can support you to design the right models for your PCNs and federations, feel free to contact our Primary Care Lead, David Segal, at David.Segal@pplconsulting.co.uk