NHSE (NHS England) commenced the PCN (Primary Care Network) DES in 2019/20 and has invested further in the DES since that time. Whilst over 95% of practices in England are members of a PCN, the perceived success of PCNs for practices and patients has varied hugely across the country. The PCN DES should not be viewed as an alternative to ensuring appropriate core contract funding which supports the delivery of general medical services.
Many feel that the requirements of the DES outweighed the benefit brought by the investment into practices and ARRS (Additional Roles Reimbursement Scheme) staff.
By signing up to the DES, practices receive a payment of £1.76 per patient (network participation payment) and PCNs receive £1.50 per patient. Further income streams come from the IIF, ARRS reimbursement, and PCN clinical director payments.
NHSE has published its proposals for PCN requirements for 2024/25 without agreement from GPCE.
Practices will need to consider if the PCN DES enables them to offer safe and effective patient care within the context of their wider practice and their present workforce.
There is a mechanism by which practices may express that they no longer choose to continue within the DES between 1 April and 30 April 2025 to their ICS, or at any point at which there is a change to the PCN DES by NHSE.
If practices remain within the DES they are contractually obliged to provide the requirements as set out, though the IIF is paid on activity. Many of the IIF activities probably derive little direct patient benefit, and the incentive associated may not be cost efficient for PCNs to undertake. As such, PCNs may elect not to undertake this work. If you choose to leave the DES, the payments to your practice associated with it would stop.
ARRS staff would no longer be able to provide services to patients on your practice list and the PCN itself could be at risk. ICSs are obliged to provide services for patients registered with practices not signed up to the PCN DES. This should mean patients continue to benefit from the services provided by PCNs, without the requirement on their practice.