July Blog: Primary Care (PCNs) and You

Primary Care Networks [PCNs] and You

Change, they say, is the one constant in life and when it comes to the NHS that certainly holds true.

Are you aware of the recent changes to the NHS landscape and, in particular, what’s happening in Derbyshire? You may well be aware that since April 2013 we had four Clinical Commissioning Groups (CCGs), but did you know the new/consolidated Derby and Derbyshire CCG (DDCCG) launched in April this year? This brought together 115 local GP practices, split between eight different places, to commission health services for Derbyshire’s population of more than 1,055,000 patients.

DDCCG is one of the partner organisations involved with our local Sustainability and Transformation Partnership (STP) – known locally as Joined Up Care Derbyshire (JUCD). The NHS Long Term Plan requires every STP to become an Integrated Care System (ICS) by April 2021; so more changes are on the way over the next couple of years.

The ICS, because it will cover the whole of Derbyshire, will truly have the capacity to support system-wide transformation of services. This includes workforce, capital and estates planning, specialised digital services and implementing changes to acute care services. This will be done under a single operating plan which encompasses both CCGs and NHS providers. The focus locally will be on new ways of working to:

• Help keep people healthy
• Give people the best quality care
• Run services well and make the most of available budgets

Under the ICS umbrella are a designated 8 ‘Places’, aimed at forming alliances which will help with integrating primary, community, local government and hospital services, with the development of new service models for anticipatory care.

Typically, a ‘Place’ will have a population of between 250-500k, but in Derbyshire this will average around 130k. The ‘Place Boards’ will be responsible for using the available resources to make sure there are equitable services for people living and working in the city and county. At this level the focus will be on:

• Supporting people to stay well for longer through a consistent set of work areas, which include frailty, falls, care homes and supporting people to die well
• Identifying what local people need in their area as regards their health and wellbeing

At an even more local level are the Primary Care Networks and here the focus is on strengthening primary care through supporting collaborative working across groups of general practices and other health and care providers, including community pharmacists. These networks will provide the structure and funding (per capita basis) for services to be developed locally, in response to the needs of the patients they serve. It is vitally important that community pharmacy teams are fully involved in the work of their PCN.

All GP practices had to be in a PCN by June 2019 and needed to sign up to a PCN Network Agreement. We are waiting for the final confirmation of the PCN geographies across Derby and Derbyshire (15 PCNs). These geographies will be confirmed in July and contractors will need to know which network area they are in. Therefore, the LPC will produce a contractor database to identify which PCN each pharmacy is aligned with.

It is important that community pharmacy teams are fully engaged with the work of the PCNs to optimise their provision of services to patients and, because the future development of local services will be influenced by PCNs. NHS England sees the initial priorities for community pharmacy engagement in PCNs to be:

• Supporting the provision of integrated urgent care services (e.g. NUMSAS and DMIRS)
• Work on prevention, such as provision of public health interventions and services, building on the work of HLPs
• Locally, other priorities may be agreed with PCN leaders, which may initially include optimising the provision of existing services, such as MUR, NMS and electronic repeat dispensing

We want to identify a ‘lead’ community pharmacist who works in each PCN to act as a main point of contact between the PCN and all the community pharmacies in that PCN geography. This will help support collaborative working, help integrate community pharmacy into the PCN, ensure robust 2-way communication and build relationships between the PCN Clinical Directors, PCN Pharmacists and Community Pharmacists.

These ‘lead’ community pharmacists will represent ALL community pharmacy contractors in the geography – not just their own pharmacy, and will be asked to feedback progress to the LPC, so we can collate and share good practices and ideas. In turn, the LPC will provide support for the ‘lead’ with communications support, advice and insights into best practice that is happening locally and nationally. If this is something you would like to be considered for please let the LPC know as soon as possible by sending an email with your contact details, including confirming which pharmacy you work in, to Jackie Buxton, LPC Chief Officer – jackie.buxton@cpderbyshire.org.uk

Also, while I have your attention, I would like to point you towards our Health Champions closed Facebook page. We are looking for members so please take a look at the page here https://www.facebook.com/groups/144590669467837/ and send a request to the group.