PCNs are groups of General Practices working closely together, with other primary and community care staff and health and care organisations, providing integrated services to their local populations.
From April 2019, the BMA’s GP committee and NHS England have agreed a DES (Directed Enhanced Service) to fund and support, individual GP practices to establish/ join PCNs covering populations of between 30,000 to 50,000 in England.
The BMA have created a handbook which provides advice and offers options to groups of practices looking to establish a PCN and it has been fully revised following the 2020/21 contract agreement.
Guidance Material for the 15th May Submission
Initial PCN Registration Information by 15th May – this is general guidance on how you get member practice sign up, agree who will be your Clinical Director and who will hold the PCN Bank Account
Guidance Material for Completing the Network DES Agreement
The Network DES Agreement is a mandatory agreement with 104 Clauses that (apart from 2 clauses regarding disputes) cannot be changed. It must be submitted by 30th June.
After the 104 clauses are 7 schedules that must be completed that are specific to the workings of your particular PCN
- The schedules to the mandatory agreement
- Schedule 1 – How the PCN holds meetings and makes effective decisions. Our guidance takes you through the elements that need to be covered in this schedule and gives suggested wording about meetings and decision making in the PCN
- Schedule 2 – Additional Terms. Our guidance suggests additional terms the PCN may want to include to supplement and expand on the mandatory clauses. (these can’t replace or contradict the mandatory clauses)
- Schedule 3 – Activities. Our guidance suggests how the activities that the PCN carries out to meet the DES requirements can be presented – what needs to be included and how much detail
- Schedule 4 Financial Arrangements. Our guidance links the financial requirement in this schedule to the activities set out in Schedule 3. It needs to cover who gets paid for what. Also included is a specimen MOU between the practices in the Network and the organisation holding the bank account.
- Schedule 5 – Workforce. Our guidance sets out the options for the employment of the “additional staff roles” that will be available to the PCN at 70% or 100% reimbursement. Included in this section are specimen Contract of Employment and a Joint Employment Agreement between the practices employing and receiving services from these staff. Further specific advice can be sought from our HR team https://nwlmcs.org/hr-services/
- Schedule 6 – Insolvency. Our guidance lists events of insolvency that would enable Members to take action under the clauses
- Schedule 7 Arrangements with organisations outside of the Network. Our guidance suggests a range of outside organisations that members may be working with that are of relevance to PCN related matters.
GDPF PCN Guidance
GPDF, in response to some worries expressed by GPs up and down the country, commissioned a firm of Solicitors, Penningtons Manches, to give advice on various aspects of the PCN DES. The advice is broad in nature but may give you some guidance in what to incorporate into your various DES Schedules to address any concerns over employment of additional staff, sharing liabilities and VAT. The LMC will be happy to advise you further on these issues.
- GPDF Guidance on Structuring PCNs
- Guidance Note 1: Completing the Mandatory Network Agreement with its Schedules
- Guidance Note 2: Employment & Pensions
- Guidance Note 3: Governance, Accountability, Liabilities & Internal Arrangements
- Guidance Note 4: Contracts, Sub-Contracts & Service Delivery
- Guidance Note 5 – VAT & Funding Implications
- Guidance Note 6: Clinical Director
The team at the LMC are keen to give any support that is necessary to PCNs to get them established and functioning. If you require specific advice, do not hesitate to get in touch; if your PCN would welcome a discussion with us we will be glad to meet with you.
We have recently delivered roadshows exploring the role of Practice Managers in PCNs and the digital revolution. To see the presentation please visit our Practice Manager Development Programme page.