At the end of the November PPL, National Voices and Cobic-Optimedis gathered a number of people working across health and care to discuss what the future of PCNs could be. In the context of the recent rejection of the new service specifications by the BMA GP's committee it is hard to think more strategically about the long term future of Primary Care Networks; it is however essential that we do so if the PCN model is to be a success. Under the thought provoking introductions from both Professor James Kingsland (previous chair of the NAPC) and Don Redding (previous Policy Director for National Voices) we did just that, investigating how PCNs could have a positive impact on people's lives. Here are our three key things we took away from the day that we believe PCNs should focus on to make a real difference:
PCN's must activate citizens and communities
Whether it be 'patient led design', 'co-production' or 'patient centred-care', it is not a new idea to place the people who use the services at the centre of the care model or as key partners in the development process. PCNs bring a new opportunity to do this effectively, operating at a scale that reflects real neighbourhoods and communities and can genuinely bring people together to fix problems that are real and relevant to that community. This must not fall in to the previous trap of appearing patronising or offering only token representation or input, but must truly engage citizens on what it would mean for them to live well in their communities. Equally this must not be a one way street, and must activate communities in becoming an essential part of the system that provides care and support for people.
This is about holistic personalised care of a population
Another term that is not new, but equally another concept that PCNs are positioned to deliver effectively. For PCNs to truly make a difference they cannot simply be another way to operationally organise General Practice. Instead they must be centred around understanding the needs of their local population, and working collaboratively to support that need in the best way possible. This will require sophisticated capability in population health management and a skilled professional workforce, but it will also require a significant shift in how leaders and organisations work in partnership for the betterment of their population.
We need to make a shift to proactive and preventative model real. In fact we need go further to deliver anticipatory care and health promotion.
The rejection of the service specifications by the GP community is centred around two arguments: we do not have enough resource and we do not have enough time. The argument is understandable given the pressure in Primary Care, but solutions must be found in the short term, to push forward the essential shift in the care model in the long term. Moving to a true model of health promotion and prevention is critical to the solving the issue of over reliance on General Practice within Primary and Community care, as well as in delivering better outcomes for people and communities.
What we can be relatively sure of is that the latest stumbling block for PCN delivery will not be the last. What is less certain is will leadership on both sides have the vision, strength and determination to deliver a game changing model for how we provide care for our local communities.