PCN response: next steps to building strong and effective ICSs across England
To produce this response, the PCN Network has engaged with PCNs across the country through a series of virtual roundtable events. These roundtables provided a platform for those working within PCNs, including clinical directors and network managers, to discuss the NHSEI proposals and offer their views and concerns.
- Overall, there is cautious optimism among PCNs about the direction of travel set out in NHS England and NHS Improvement’s paper. It is broadly felt that formalising system working and embedding collaboration at place will be beneficial for population health in the long term.
- The reason for caution is that while there is support for many of the basic premises set out in the paper, there is concern about what the detail will look like in certain areas. Notably, these include:
- the division of responsibilities between system and place
- governance and PCN representation within systems
- the financial risk to primary care budgets.
- More comprehensive concerns on these issues and others are provided in our response to the four questions posed by NHS England and NHS Improvement.
- Without knowing such details, it is difficult for PCNs to visualise how systems will operate in future and what the PCN role will be within them. Our response can therefore be summarised with a quote from one clinical director who said “the devil is in the detail and the detail doesn’t exist”.