PCN Strategies – Fairlop PCN Experience 

Is your PCN running effectively? Are you maximising the services available? Do you have a fixed business plan? How about financial strategy? We recently worked with Fairlop PCN to deliver all of the above, where we provided specific steps for the PCN to take to ensure these are delivered.

‘Everyone’s talkin’…sang Harry Nillson rather a long time ago. Well, maybe not everyone. But many PCNs are discussing how best to utilise their ARRS spend and what other income is available.  They are looking to maximise the impact for their practices, talking about the ICS asks and thinking about the many more enhanced services that seem likely to be transferred to PCNs.

The importance of PCN strategies

A recent article in Pulse spoke of the value of PCNs throughout the pandemic, but there was an emphasis on PCNs given the right support and opportunities to help drive system-level decision-making. On top of this, there should be a clear and executable strategy in place.

Many PCNs have not translated their discussions into a multi-year strategy. The outcome often being the use of a series of short-term plans to maximise the available ARRS funding and, possibly, IIF receipts. The actions to integrate the PCN staff with the practices have not been planned. The impact being many recruited staff struggling to find a meaningful role or place. Their full potential for either patients or practices is not realised. And, in turn, the hoped-for growth of the PCN and increased impact never materialises.

Perhaps it’s time to revisit your PCN strategy and financial planning? Here’s what we delivered for Fairlop PCN – and, more importantly, what the PCN got out of it.

The Clinical Director said “Forming our business plan provided the drive we needed to identify solutions to the increasing capacity and organisational issues we faced. The At Scale team provided us with space we needed to think about the PCN role beyond simply delivering the immediate DES requirements.”

It’s important to note that the most ambitious PCN may still have challenges with the planning time to develop and deploy a Strategic and Financial Plan. At Scale worked with Fairlop PCN in Redbridge to assist with such planning. Fairlop PCN serves a population of around 46,000 patients and has 7 member practices.

It has a mixed demographic with pockets of deprivation and disease prevalence common to East London. Fairlop has ambitious and challenging plans to improve the health of its population both immediately and in the future.

The PCN decided to take stock of its future planning and financial management to maximise its delivery and ensure a resilient and forward-thinking organisation. Together, we identified the PCN’s ambitions and priorities and those of its practices. A short position paper helped set out the core aspirations for the PCN, the current and future context, DES requirements and a clear analysis of anticipated future funding. A workshop with all practices helped forge a consensus on development priorities and utilising ARRS funding.

Franco La Faci the PCN Manager comments here: “The planning workshop, facilitated by the At Scale team, helped us create a business plan that clearly sets out the PCN’s future workforce and financial plans. Involving practices was so important as they are central to achieving those plans. Practice buy-in is critical to delivering services, targets and ambitions. The workshop helped provide the PCN management with a clear mandate within a clear business model that allows the financial impact of future decisions to be understood.”

The business plan developed recognises the need for flexibility, driven, in part, by workforce shortages that can make planned recruitment difficult. A vital element of the plan centres on integrating PCN staffing with practices. The pandemic has impacted resources, services and staffing, but issues such as location, space, remote working, employing status of the new roles exist even in non-Covid times. The business plan focuses on the need for clinical leadership and coordination, providing specific steps the PCN will take to ensure these are delivered and the PCN services and staff integrated into the work of the practices.

There remains much for the PCN to do. The Fairlop team is currently focused on delivering better integration and working more effectively with other parts of the health system. In common with all PCNs, a vital issue is ensuring they are clear about their place in their developing ICS and ensuring they have a strong voice. The true at scale benefits are yet to be realised but becoming more strategic means building a practical plan towards them that all practices buy into.