Primary care network

Last updated

A Primary care network is a structure which brings general practitioners together on an area basis, possibly with other clinicians, to address chronic disease management and prevention. In 2022 the term is used in England, Singapore and Alberta.

Contents

England

Primary care networks were introduced into the National Health Service in England as part of the NHS Long Term Plan, published in January 2019. The 2019 General Practitioner contract gave the opportunity for GP practices to join networks, each with between 30,000 and 50,000 patients. The stated aim is to create fully integrated community-based health services [1] which will be an important component of integrated care systems. [2] They are based on GP registered patient lists, and intended to serve natural communities of between 30,000 and 50,000 people. It is the location of the GP, not the patient, which determines which one a patient is attached to. [3]

By June 2019 1,259 primary care networks had been established across England, with an average population covered of about 42,000 patients, and including all but about 55 practices. About 25 had decided not to participate. [4]

Networks are required to deliver seven national service specifications. Structured medication reviews, enhanced health in care homes, anticipatory care (with community services), personalised care and supporting early cancer diagnosis were to start by April 2020. Cardiovascular disease case-finding and locally agreed action to tackle inequalities are to start in 2021.

This model was pioneered by the vanguard projects established under 2014's Five Year Forward View. The networks will hold local contracts for enhanced services. They will have 'expanded neighbourhood teams', which the plan envisages 'will comprise a range of staff such as GPs, pharmacists, district nurses, community geriatricians, dementia workers and allied health professionals such as physiotherapists and podiatrists/chiropodists, joined by social care and the voluntary sector'. [5]

Evidence of the effectiveness of this approach is rather limited, according to a 2019 review in the Health Policy journal. [6]

Modality Partnership and Our Health Partnership, two of the biggest GP super-partnerships, proposed in 2019 to lead networks across the country, which may include practices not in their organisations. [7]

Staffing

Funding is provided for the employment of clinical pharmacists and social prescribing link workers in 2019/20, and subsequently for physiotherapists, physician associates and paramedics. [8] Each network was given £37,810 to fund a clinical pharmacist post for 2019/2020, to cover 70% of the costs, with the network expected to cover the rest. The intention is that each network will have five clinical pharmacists by 2024 – about one per practice [9] – providing altogether an additional 7,500 pharmacists. [10] In June 2022 there were 3,294 full-time equivalent pharmacists recorded as working in primary care networks, an increase of about 700 since 2021. [11]

In November 2019 NHS England announced a change in financial rules which will permit networks to meet management costs of the charities and other organisations which supply social prescriber link workers. [12]

The NHS Confederation has established a Primary Care Network which is intended to be a voice for the sector. [13]

Alberta

In Alberta primary care networks are partnerships between a groups of family physicians and Alberta Health Services which work with teams of health care professionals, such as nurses, dietitians and pharmacists. 84% of primary care physicians are registered with them and close to 3.8 million Albertans are enrolled with a PCN. There is a Provincial PCN Committee which includes representatives from PCNs, Alberta Health Services, the Alberta Federation of Regulated Health Professionals and the Alberta Medical Association. [14]

Singapore

The Singapore Ministry of Health introduced the Primary Care Networks scheme to encourage private General Practitioner clinics to organise themselves into networks that support more holistic and team-based care. They have a multi-disciplinary team including doctors, nurses and primary care coordinators. Diabetic foot and eye screening, and nurse counselling is included. From January 2018 ten PCNs were in operation. [15]

Related Research Articles

General practice is the name given in various nations, such as the United Kingdom, India, Australia, New Zealand and South Africa to the services provided by general practitioners. In some nations, such as the US, similar services may be described as family medicine or primary care. The term Primary Care in the UK may also include services provided by community pharmacy, optometrist, dental surgery and community hearing care providers. The balance of care between primary care and secondary care - which usually refers to hospital based services - varies from place to place, and with time. In many countries there are initiatives to move services out of hospitals into the community, in the expectation that this will save money and be more convenient.

<span class="mw-page-title-main">Family medicine</span> Medical specialty

Family medicine is a medical specialty within primary care that provides continuing and comprehensive health care for the individual and family across all ages, genders, diseases, and parts of the body. The specialist, who is usually a primary care physician, is named a family physician. It is often referred to as general practice and a practitioner as a general practitioner. Historically, their role was once performed by any doctor with qualifications from a medical school and who works in the community. However, since the 1950s, family medicine / general practice has become a specialty in its own right, with specific training requirements tailored to each country. The names of the specialty emphasize its holistic nature and/or its roots in the family. It is based on knowledge of the patient in the context of the family and the community, focusing on disease prevention and health promotion. According to the World Organization of Family Doctors (WONCA), the aim of family medicine is "promoting personal, comprehensive and continuing care for the individual in the context of the family and the community". The issues of values underlying this practice are usually known as primary care ethics.

A consultant pharmacist is a pharmacist who works as a consultant providing expert advice on clinical pharmacy, academic pharmacy or practice, public health pharmacy, industrial pharmacy, community pharmacy or practice, pharmaceutical analysis etc., regarding the safe use and production of medications or on the provision of pharmaceutical services to medical institutions, hospitals, universities, research institutions, medical practices and individual patients.

General medical services (GMS) is the range of healthcare that is provided by general practitioners as part of the National Health Service in the United Kingdom. The NHS specifies what GPs, as independent contractors, are expected to do and provides funding for this work through arrangements known as the General Medical Services Contract. Today, the GMS contract is a UK-wide arrangement with minor differences negotiated by each of the four UK health departments. In 2013 60% of practices had a GMS contract as their principle contract. The contract has sub-sections and not all are compulsory. The other forms of contract are the Personal Medical Services or Alternative Provider Medical Services contracts. They are designed to encourage practices to offer services over and above the standard contract. Alternative Provider Medical Services contracts, unlike the other contracts, can be awarded to anyone, not just GPs, don't specify standard essential services, and are time limited. A new contract is issued each year.

<span class="mw-page-title-main">NHS primary care trust</span>

Primary care trusts (PCTs) were part of the National Health Service in England from 2001 to 2013. PCTs were largely administrative bodies, responsible for commissioning primary, community and secondary health services from providers. Until 31 May 2011, they also provided community health services directly. Collectively PCTs were responsible for spending around 80 per cent of the total NHS budget. Primary care trusts were abolished on 31 March 2013 as part of the Health and Social Care Act 2012, with their work taken over by clinical commissioning groups.

<span class="mw-page-title-main">NHS Scotland</span> Publicly-funded healthcare system in Scotland

NHS Scotland, sometimes styled NHSScotland, is the publicly funded healthcare system in Scotland and one of the four systems that make up the National Health Service in the United Kingdom. It operates 14 territorial NHS boards across Scotland, supported by seven special non-geographic health boards, and Public Health Scotland.

Health and Social Care (HSC) is the publicly funded healthcare system in Northern Ireland. Although having been created separately to the National Health Service (NHS), it is nonetheless considered a part of the overall national health service in the United Kingdom. The Northern Ireland Executive through its Department of Health is responsible for its funding, while the Public Health Agency is the executive agency responsible for the provision of public health and social care services across Northern Ireland. It is free of charge to all citizens of Northern Ireland and the rest of the United Kingdom.

SystmOne is a centrally hosted clinical computer system developed by Horsforth-based The Phoenix Partnership (TPP). It is used by healthcare professionals in the UK predominantly in primary care. The system is being deployed as one of the accredited systems in the government's programme of modernising IT in the NHS.

Out-of-hours services are the arrangements to provide access to healthcare at times when General Practitioner surgeries are closed; in the United Kingdom this is normally between 6.30pm and 8am, at weekends, at Bank Holidays and sometimes if the practice is closed for educational sessions.

Healthcare in London, which consumes about a fifth of the NHS budget in England, is in many respects distinct from that in the rest of the United Kingdom, or England.

The Five Year Forward View was produced by NHS England in October 2014 under the leadership of Simon Stevens as a planning document.

The Modality Partnership is a large GP partnership formed in 2009. Such large practices are often described as a "super partnership". According to the King's Fund in 2016 it was one of England’s largest super-practices. In 2018 it had about 400,000 patients and was thought to be the largest practice in England.

EMIS Health, formerly known as Egton Medical Information Systems, supplies electronic patient record systems and software used in primary care, acute care and community pharmacy in the United Kingdom. The company is based in Leeds. It claims that more than half of GP practices across the UK use EMIS Health software and holds number one or two market positions in its main markets. In June 2022 the company was acquired by Bordeaux UK Holdings II Limited, an affiliate of UnitedHealth’s Optum business for a 49% premium on EMIS’s closing share price.

Healthcare in the West Midlands was, until July 2022, the responsibility of five clinical commissioning groups: Birmingham and Solihull, Sandwell and West Birmingham, Dudley, Wolverhampton, and Walsall.

Pharmacy in the United Kingdom has been an integral part of the National Health Service since it was established in 1948. Unlike the rest of the NHS, pharmacies are largely privately provided apart from those in hospitals, and even these are now often privately run.

Lakeside Healthcare Groupwhich operates from a number of sites across Cambridgeshire, Lincolnshire and Northamptonshire, is one of the biggest General practice / Primary Care Providers in the National Health Service with 80 partners and almost 200,000 patients.

<span class="mw-page-title-main">Nick Harding</span> British general practitioner

Professor Nick Harding OBE BSc FRCGP FRCP HonMFPH DRCOG DOccMed PGDIP (Cardiology) SFFLM, born 21 December 1969, is a British general practitioner and Chief Medical Officer at Operose Health.

The National Association of Primary Care is a membership association for Primary care professionals in the National Health Service and is the primary care provider network of the NHS Confederation.

GP Federations became popular among English general practitioners after 2010 as a means to exploit the opportunities—or mitigate the threats—posed by the Five Year Forward View proposals in the English NHS which envisaged delivering primary care at a larger scale than the traditional GP list. It is widely believed that ‘Practices cannot survive on their own – they have to look at ways of making themselves stronger.’ 15 sites were selected in December 2015 to test new enhanced primary care models serving populations of 30,000 to 50,000 patients. Some, but by no means all, clinical commissioning groups have given financial support to encourage the formation of federations.

In England, an integrated care system (ICS) is a statutory partnership of organisations who plan, buy, and provide health and care services in their geographical area. The organisations involved include the NHS, local authorities, voluntary and charity groups, and independent care providers. The NHS Long Term Plan of January 2019 called for the whole of England to be covered by ICSs by April 2021. On 1 July 2022, ICSs replaced clinical commissioning groups in England.

References

  1. ↑ "Primary care networks are about much more than general practice". Health Service Journal. 6 February 2019. Retrieved 17 March 2019.
  2. ↑ "PCNs need right support to manage local population health". Health Service Journal. 2 August 2021. Retrieved 6 September 2021.
  3. ↑ "Primary care networks". NHS England. Retrieved 15 November 2022.
  4. ↑ "GPs to form 1,300 primary care networks". Health Service Journal. 27 June 2019. Retrieved 23 August 2019.
  5. ↑ "New GP contract to mandate practices to join primary care networks". Pulse. 7 January 2019. Retrieved 17 March 2019.
  6. ↑ Pettigrew, Louisa; Et, al (January 2019). "Lessons for 'large-scale' general practice provider organisations in England from other inter-organisational healthcare collaborations". Health Policy. 123 (1): 51–61. doi: 10.1016/j.healthpol.2018.10.017 . PMID   30509873.
  7. ↑ "Superpractices looking to take leadership roles on GP networks across England". Pulse. 12 April 2019. Retrieved 16 April 2019.
  8. ↑ "Primary care networks explained". Kings Fund. 13 March 2019. Retrieved 7 May 2019.
  9. ↑ "Every primary care network to get £38,000 to fund new clinical pharmacist role in 2019". Pharmaceutical Journal. 31 January 2019. Retrieved 17 March 2019.
  10. ↑ "Number of clinical pharmacists expected to work in PCNs rises to 7,500 by 2023/2024". Pharmaceutical Journal. 16 September 2019. Retrieved 19 November 2019.
  11. ↑ "Number of pharmacists working in primary care networks has increased by a third over past year". Pharmaceutical Journal. 1 August 2022. Retrieved 29 September 2022.
  12. ↑ "PCNs permitted to pay charities' management costs". Health Service Journal. 27 November 2019. Retrieved 11 January 2020.
  13. ↑ "Primary Care Network". NHS Confederation. Retrieved 15 November 2022.
  14. ↑ "Primary health care". Government of Alberta. 2022. Retrieved 15 November 2022.
  15. ↑ "PRIMARY CARE NETWORKS". Ministry of Health (Singapore). 2020. Retrieved 15 November 2022.
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.