If you are a surgery or general practice looking to win substantial contracts or funding, it can be a daunting prospect, particularly if you are an already over-worked GP or Practice Manager struggling for time.
What types of GP contracts can you bid for?
APMS (Alternative Provider Medical Services) contracts are regularly put out to tender by the NHS commissioners – usually Integrated Care Boards or local authorities – every week on the Government’s Find a Tender website. This type of contact enables private sector companies to provide primary care services. They can also be used as a vehicle to commission contracts for services that are outside the scope of core general practice such as helping individuals or groups not signed up to surgeries, for example asylum seekers or the homeless.
PMS (Personal Medical Services) contracts were hugely popular and generally facilitated by NHS England and Clinical Commissioning Groups but these are being phased out in favour of a new Integrated Care Provider (ICP) contract to allow for a better integration of services.
GMS (General Medical Services) contracts are the national standard GP contract.
We tend to work more on bids for APMS contracts and, in partnership with PMA, are here to support and guide GPs and Practice Managers through the tender bid process.
In fact, we have bid on more than 300 health and social care contracts with a win rate of 93%, securing £1 billion in contracts and funding for our clients.
Is there any general practice funding available in the UK?
The latest NHS England waiting list figures, up to November 2023, stand at 7.6 million. That’s 7.6 million people who are all waiting to start elective/non urgent treatments in England.
While this has dropped ever so slightly from 7.7 million in October 2023, it is still much larger than the 7.2 million it was just a year ago in November 2022.
According to The Lancet, NHS England’s recovery plan aims to increase capacity by up to 30%, compared with pre-pandemic levels, over the next three years through a range of measures, including extra staff and increased use of the independent sector.
Due to this significant, unprecedented pressure on our healthcare system, we anticipate that there will be additional funding opportunities for GP Practices and Primary Care Networks (PCNs) made available by NHS England.
The General Practice Improvement Programme (GPIP), for example, provides nationally funded support for practices and primary care networks (PCNs) to implement modern general practice.
There is also funding available to GP practices to help them with going digital, such as cloud-based telephone systems, online consultation software and new appointment booking systems.
If you need help with winning GP contracts or funding, get in touch with K Low Consulting today to see how we can assist you. Contact info@klowconsulting.com or give us a call on 0330 133 1041.
Earlier this year, the Care Quality Commission (CQC) announced it would be making changes to the way it works with suppliers and providers. These changes would include the establishment of a new assessment framework and provider portal and will apply to providers, local authorities and integrated care systems.
Over the course of 2023, these plans progressed and the new portal started being rolled out in September with providers being invited to join in phases.
The new framework will start being used in November, again being rolled out in phases. These phases will be in geographic regions, starting with providers in the South of England, with a view to the framework working as standard from April 2024 for all providers.
The framework will retain the five key questions, but six new evidence categories will be introduced. There will also be quality statements which will focus on specific topic areas, based on people’s experiences and the standards of care they expect. These will replace the key lines of enquiry (KLOEs), prompts and ratings characteristics.
What do you need to do if you are a CQC provider?
The CQC will contact you when it is time for you to join the portal, so our advice would be to make sure they hold up to date contact details for you so you receive your portal invite and login details. You can also subscribe to receive email updates so you are kept informed of any changes as and when they are rolled out.
Also, you will be required to submit a lot more evidence, so start gathering this now.
Implications and considerations
Here at K Low Consulting, we are in a unique position. We are not a supplier or service provider to the CQC but many of our clients are. We are trusted by providers and can speak for them.
Having attended the Care Show 11 – 12 October in Birmingham and hearing a briefing from James Bullion, Chief Inspector of Adult Social Care and Integrated Care at the Care Quality Commission, we feel that these changes to the CQC Framework have big implications and we have some very real concerns that need serious consideration.
Firstly, this new framework is evidence-based, with the onus on the provider to gather and provide evidence themselves.
Since Covid, the CQC has had to carry out more desk-based audits and, if any problems were identified, a follow up inspection would take place. Even then, the CQC has struggled to meet demand and keep up with the number of in-person inspections required. So, it was obvious that any new process would need to be more efficient for the CQC.
But, with providers submitting their own evidence and quality statements, face-to-face inspections will be a thing of the past completely. Essentially, providers and suppliers can tell the CQC what they like and won’t be interviewed or tested on aspects such as safeguarding, which could adversely affect patient safety.
Another concern is that the framework is effectively becoming a self assessment process, with no independent audits or inspections taking place.
Lastly, National Institute for Health and Care Excellence (NICE) guidance and the NHS Long Term Plan identify patient-centred care as being central to good quality health services and recommend giving patients greater control over their own health and ensuring they have more personalised care when they need it. There has also been much made of the importance of the ‘patient voice’, encouraging patients to have their say on the health services they use. As part of the new framework, case studies and service user testimonials can be submitted but, as the provider is responsible for collating and uploading these, will they be truly representative? Should patients and service users be interviewed by someone independent?
It will be interesting to see how the new portal and framework pans out and we will look to do a follow up blog in due course.
Further information and guides for providers can be found on the CQC website.
We are pleased to announce that David Oakes, who has been working with us as a consultant for the last two years, has now joined the business as a company director.
David brings a detailed understanding of the health and social care bidding landscape drawing directly upon roles within local government commissioning, charity, third and the private-sector organisations. The experience allows him to provide clients with a detailed understanding of each opportunity, working with them to develop the bid ‘culture’ and associated strategies needed to deliver outstanding submissions – as evidenced by an 89% win rate across all submissions.
David started working with our founder Krisja Low after meeting at the Minor Oak co-working space in Nottingham just over two years ago. They soon realised their skills and experience complemented each other and David has gone on to work for K Low Consulting on a variety of projects, showing dedication, commitment and passion to both the business and its clients.
David said: “I am hugely excited to come on board as a director at K Low Consulting. Our working relationship has really developed over the last two and a half years and works really well.
“I’m also really excited about the increasing number of tender opportunities relating to health tech. From virtual wards to the hybrid way of working, this sector is only going to grow over the coming months and years and that is great news for the innovative businesses developing and offering these services and technological solutions.”
FOR many industries, the pandemic has had a lasting impact, fuelling many new opportunities for growth and change, particularly in healthcare where virtual wards are now commonly used.
It’s a process which largely began during the early days of lockdown, when businesses had to react quickly to find new ways of working remotely, embracing technology to ensure they stayed connected to their staff, clients – and even their patients.
Now, as we begin to emerge from the pandemic, some of these processes have remained in place, bringing with them enormous benefits – and exciting new opportunities – for healthcare providers and their patients.
As experts in the healthcare sector, K Low Consulting can help you learn more about these important developments, develop your strategy, help you create winning tender bids and grow your business.
What is a virtual ward?
Virtual wards allow patients to get the care they need at home, safely and conveniently, freeing up hospital beds for patients who really need them.
Supervised by hospital and community-based clinicians, virtual wards allow conditions such as coronavirus to be dynamically monitored while the patient stays in the comfort of their own home. For example, coronavirus patients can be discharged safely to a virtual ward with an oximeter – a small, lightweight device which measures the amount of oxygen in their blood. Readings are taken regularly and fed into the patients health tracking system. The system is configured to identify outlier readings, flagging these to both the patient and the clinical team for closer monitoring and escalation where required (either via video call or face-to-face visit).
The approach is all part of the NHS@Home programme which is building on the lessons learned from the pandemic, to enable patients to access personalised healthcare at home, rather than having to make appointments with their GP or make lengthy journeys to their local hospital.
It’s a growing trend which isn’t going anywhere. By December 2023, The Nuffield Trust estimates that the NHS will have 40-50 virtual ward ‘beds’ per 100,000 people.
What do virtual wards mean for my business?
The move to virtual wards is opening up new opportunities for businesses to get involved in the healthcare sector, particularly those involved in the manufacture of monitoring equipment including oximeters and heart monitors and healthcare providers, including care homes, who can demonstrate a clear technology strategy.
Businesses who can provide data management systems, which ensure patients’ data is managed securely and legally, are also likely to be in high demand.
How can K Low Consulting help me to expand my business?
When it comes to tender bids within the healthcare sector, we can help you to open doors.
We’ve successfully created hundreds of bids for our clients, leading to £1 billion in healthcare contracts for NHS England, Clinical Commissioning Groups (CCGs) and the public health sector.
We work with all stakeholders to fully understand the challenges, using these insights to help our clients showcase their strengths and demonstrate how their business is best-placed to offer the best solutions.
If you would like more information or if would like to be made aware when relevant tender opportunities come up in your industry or field of expertise, contact us today on 0330 1331 041 or info@klowconsulting.com to see find out how we can help you.
At the end of June, NHS England (NHSE) announced plans to transform the way integrated care systems (ICSs) buy non NHS goods and services in a document entitled NHS System Oversight Framework 2021/22.
But what is the significance of this framework? And what will it change for companies and organisations looking to land NHS contracts?
What is the NHS System Oversight Framework?
The NHS System Oversight Framework for 2021/22 replaces the NHS Oversight Framework for 2019/20, which brought together arrangements for provider and Clinical Commissioning Groups (CCGs) oversight in a single document.
This framework applies to all Integrated Care Systems (ICSs), Clinical Commissioning Groups (CCGs), NHS trusts and foundation trusts and focuses on five key metrics:
Quality of care
Access and outcomes
Preventing ill health and reducing inequalities
People; finance and use of resources
Leadership and capability
The approach to oversight is characterised by the following key principles:
a. working with and through ICSs, wherever possible, to tackle problems
b. a greater emphasis on system performance and quality of care outcomes, alongside the contributions of individual healthcare providers and commissioners to system goals
c. matching accountability for results with improvement support, as appropriate
d. greater autonomy for ICSs and NHS organisations with evidence of collective working and a track record of successful delivery of NHS priorities, including tackling inequality, health outcomes and access
e. compassionate leadership behaviours that underpin all oversight interactions
Implementation of the framework
While the scope of this framework reflects the role of NHS England and NHS Improvement as a national regulator of NHS provided and/or commissioned services, it also recognises that ‘the vision for ICSs is based on the core principles of equal partnership across health and local government: subsidiarity, collaboration and flexibility’ and that ‘delivering the priorities for the NHS depends on collaboration across health and care, both within a place and at scale’.
But implementing the framework won’t be easy and straight forward.
NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.
But implementing the framework won’t be easy and straight forward.
NHS leaders are looking for specificity in how oversight will operate within a system context and there will need to be a high degree of flexibility to design approaches that best reflect local circumstances and maintain ownership and engagement across the full range of system partners.
When will the framework be implemented?
The existing statutory roles and responsibilities of NHS England and NHS Improvement in relation to trusts and commissioners remain unchanged for 2021/22. The framework sets out how NHS leaders and organisations will be required to operate with their partners in ICSs from April 2022.
The oversight framework will be updated further for 2022/23. The updated document is expected to confirm ICSs’ formal role in oversight including:
bringing system partners together to identify risks, issues and support needs and facilitate collective action to tackle performance challenges
and
leading oversight and support of individual organisations and partnership arrangements within their systems.
What does it all mean going forward?
The thinking behind the framework is that local NHS procurement teams will be able to change the way they buy non-NHS goods and services and move towards a more system-level way of working, and away from procurement teams dedicated to single organisations.
ICSs will be able to “tailor their procurement organisation structure based on their respective level of maturity, spend profiles, associated phasing of roles and local considerations” but the lack of data harmonisation at local, regional and national level and clarity around best practice approach could make implementation difficult.
With regards to companies who are looking to supply the NHS at a local level, they will have to keep an eye on how this framework develops between now and April 2022 and establish relationships with the ICSs who will soon be in charge of their own procurement and spending.
If you are looking for help with securing NHS contracts, contact the K Low Consulting team on 0330 1331 041 or info@klowconsulting.com.
We’ve all seen the worrying headlines about the growth in NHS waiting lists following the onset of the Coronavirus pandemic.
Just this week it has been reported in the national news that the number of people on NHS waiting lists hit a 12-year high. At least 162,000 patients are waiting more than a year for routine operations and the total NHS waiting list for routine treatments reached 4.4 million at the end of October. More than a third of those patients had been waiting more than 18 weeks – the NHS target for waiting times, from referral to treatment.
As the NHS continues to suspend operations as it tackles the Coronavirus epidemic, experts are expecting to see these waiting list figures rise even further in 2021.
To tackle this growing problem, NHS bosses need to introduce additional capacity into the system and one of the ways they are looking to do this is through a concept called insourcing.
What is insourcing?
Similar to outsourcing, insourcing would see the hospital ask an external provider to get an activity, contract or job completed on their behalf using their own people and equipment. The difference with insourcing is that the external company would bring their own people and equipment to the hospital and manage everything on the hospital’s own site.
This is a growing concept and one which we can reasonably expect to see taking a strong foothold in the NHS in 2021 as it struggles to bring down the growing waiting lists.
What does the growth of NHS insourcing mean for businesses?
The growth of insourcing by the NHS is likely to present some tender opportunities for private companies or medical professionals in the healthcare industry.
The types of services that hospitals are looking to secure support with could include:
NHS inpatient and outpatient (including full supporting pathology and imaging) services and urgent elective care and cancer treatment to service users in line with nationally set criteria; and
NHS inpatient non-elective care (either direct admission or transfer from an NHS organisation).
Forward-thinking businesses in the health sector have already identified insourcing as a growing area. For example, UK and Ireland healthcare service provider, Totally, launched its new insourcing venture, Totally Healthcare, in October. It said it was starting the venture primarily to reduce NHS waiting times by providing a range of procedures and services within NHS hospitals, taking advantage of spare capacity typically during weekends and bank holidays. A few weeks ago, it revealed its insourcing services have secured significant contracts across its target markets and it now classes itself as ‘key partners’ to the NHS.
Who does the NHS want to work with?
NHS Commissioners are open to working with private providers of all sizes, for a wide range of clinical activities across the country. There are national frameworks like NHS SBS aimed at all size organisations and locations, alternatively we have seen individual NHS Trusts selecting exclusive providers to meet their local requirements.
All indications are that we will see insourcing playing a greater role in the immediate future of the NHS as part of its efforts to bring waiting lists down.
If you need help with commercial bid writing, get in touch with K Low Consulting today to see how we can assist you.
NHS England’s PDPS APMS Contract has now been released on January 23rd and encourages all GP providers who wish to bid in the future, to apply as soon as possible.
In case you haven’t seen our previous blog posts about the contract, the APMS PDPS Contract was announced in October and presented the launch of a new online procurement tool (Pseudo Dynamic Purchasing System, PDPS).
NHS England and NHS Improvement (NHSEI) are seeking to launch a new online purchasing system (PDPS) where pre-approved GP providers can apply to join a list of pre-approved providers. Those providers approved to join the system can then be invited by local commissioners to bid to provide APMS services when local needs arise.
The contract is a 4-year procurement exercise managed through a new eProcurement platform and will see:
GP Providers appointed to an electronically managed list of approved providers
GP Providers can apply and be added to this list at any time during the 4-year period, unlike a traditional procurement framework,
Once approved onto the PDPS, GP providers can be invited via the ePlatform to respond to requests for APMS Services from local commissioners. These local ‘call-offs’ will be matched to the bespoke needs of local commissioners.
For more information on this, and a full description of the contract, please refer to this website:
As stated in our previous blog post, GP providers with an interest in providing routing and/or caretaker APMS services are encouraged to apply to be on the PDPS.
Any GP can apply for this contract and interest can be from a local GP contract holder within a Primary Care Network or a larger GP contract holder and other healthcare providers such as caretakers.
Please note that application to the approved provider list does NOT commit you to provide APMS services but does mean you will be able to bid when local needs arise. Thus, it is worth considering this contract carefully if you wish to bid for local services in the future.
Contract Deadline
As stated on the contract announcement, the deadline is 2024. Although, if a call-off happens you must already be on the framework to respond. It is critical that you consider applying as soon as possible for this contract.
To find out more information about the PDPS contract, please read our previous blog posts:
We’ve had a great year at K Low Consulting and are excited about the new year ahead! In this article, our team reflects on 2019 and looks ahead to the future of K Low Consulting.
In 2019, we have experienced significant and rapid growth. We have expanded our associate team, which includes bid professionals with significant writing and management experience, senior clinicians and specialist advisors, such as quality management and accreditation. Our team has been in high spirits throughout the year, keeping up with client demand and workload.
An intern from Nottingham Trent University’s graduate scheme, Mia Penny, was employed as a ‘Marketing and Tender Executive’. With the help of another associate writer from the team, Victoria, they have experienced some fantastic marketing wins in 2019.
“From September 2019 I joined K Low Consulting as a ‘Marketing and Tender’ intern after studying a master’s degree in Media and Public Relations at the University of Leicester. Since joining, I have been involved in different aspects of the business and have benefitted from hands-on experience from the outset. Krisja has helped me in developing my skill set and has guided me when learning new skills. Shadowing Krisja and being heavily involved in daily business activities has been challenging but exciting! I have particularly enjoyed being involved in Marketing the company and launching the website, which has resulted in some fantastic marketing wins at this early stage! I’m looking forward to the year ahead and seeing where my role at K Low Consulting takes me.” -Mia Penny, Marketing and Tender Executive.
Wins of 2019
Within our first year, we have had some fantastic results. Our STATS have been evidence of our work this year, we have had circa. 88% of client wins, 90% client retention and delivered 615% social return on investment for an £800k contract.
We strive to strengthen current partnerships with our clients in 2020, helping them to win more high-value contracts and develop their organisations even further. Looking ahead to 2020, we’re seeking to create more partnerships and build our client base.
Progressing on to a digital landscape, 2019 saw the launch of our website and social media accounts. Since the launch, we have had some remarkable results, including being on the first page of Google within 5 weeks of the website launch.
Some Testimonials from 2019
“Krisja and his team are knowledgeable about the Education industry and approached the tender in a systematic and organised manner. Although there was a tight deadline, they went above and beyond to involve themselves with our organisation and gather as much information as possible to produce an excellent tender response. They provided a fresh input into any potential issues and identified these in the early stages. For our most recent project with Krisja, we have been invited to the next stage and we are confident that we will win the tender. I would recommend Krisja and his team to anyone, and plan to work with him in many more projects in the future. Thanks again for the hard work.”
-Business and Resources Executive, Educational Establishment.
“… Thank you so much for the effort you and your team put in. You kept us on track throughout the submission process and although we only had a short amount of time to work on this tender, you covered every answer in-depth & we were very pleased with that we had pulled together! Pleasure to work with.”
Chief Executive Officer, Specialist Social Care Recruitment Provider.
“This is the second NHS dental tender we have worked with Krisja on. We won the first and are very confident of our chances on the second. He is always professional, diligent and flexible. His knowledge and input on healthcare bid strategy, delivery models, and commissioner perception is excellent. He always goes beyond compliance, to find creative ways of making our proposal the very best it can be!”
In 2020, K Low Consulting plans to continue assisting our clients to produce outstanding results. We carry through our ethos and values, continuing to win tenders for clients. There are also plans underway to deliver tender and funding workshops to Practice Managers after partnering up the Practice Managers Association (keep an eye out on details to follow!).
We’re also heavily involved in with the development and launch of an innovative Healthtech tool, MSK Gateway. This tool supports GPs to reduce appointment time, improve patient experience and outcomes. It enables GPs to manage their patients better by assigning them tailored exercises based on their symptoms. This year the tool will be launched into pilot practices, thus, we are looking for partner practices to use the tool to improve patient experience and outcomes. Check out the video below to see a promotional clip for MSK Gateway.
Contact Us Today
If you need help with tendering, give us a call today to see how we can assist you. Contact info@klowconsulting.com or give us a call on 0330 133 1041.
The tender process is often complex and requires close attention to the contract requirements and your organisations’ suitability to a contract.
As part of our services at K Low Consulting, we help clients to make a ‘bid or no bid’ decision in the initial stages of bidding. This often includes evaluating compliance and eligibility, commercial feasibility and competitor analysis.
After overlooking 100s of bids in different industries, it is often encountered that clients are keen to bid for a tender that may not be particularly beneficial to them. The attractiveness of a tender, therefore, is not a reason to bid. There should be careful consideration of many factors.
Providing critical feedback at the initial stages of bidding has placed us in a strong position to advise on how you can come to an informed decision regarding whether to ‘bid or not to bid’ for an upcoming tender.
Factors that may inform the ‘bid no bid’ decision
The bigger the contract, the higher the risk involved when bidding for a tender. Without carefully planning and evaluating if your organisation can deliver the contract requirements, you could be at risk of wasting time, money and resource by bidding for a contract that isn’t right for your organisation.
Here are some of the implications of bidding for a tender that isn’t right for you:
Time
Bidding for a tender takes a considerable amount of time. From undertaking research and collecting evidence, the tender process can be long, complex and require a lot of attention.
Answers will vary from tender to tender, but often, some may require a lengthy response which seeks evidence on how your organisation can deliver the contract. Thus, it is critical that you have internal teams or external bid writers to allocate the correct amount of time needed to undertake the project.
Those in senior management positions usually have to collect the right resources for the bid, which means there may be less focus on training and managerial activities. Employing an external bid team, however, could ensure that time is saved and take the strain off internal bidding teams and senior management.
Cost
There are a lot of costs associated with tendering. If you are choosing to invest in an external bid writer(s), then this will be one of the associated costs.
Evaluating that your business can afford to implement a contract is fundamental. Thus, you must be aware of the additional costs associated with a new contract. It is vital that you understand your current delivery model and what it would take to deliver a new one.
Questioning: have we got the costs to scale up? Would be a good starting point. Some of the additional costs to implement a new contract may be:
Recruitment of staff
ICT
Property
Construction
Marketing and advertising
Equipment
Wasted Resource
Resource can easily be wasted if the tender that your organisation is bidding for isn’t right for you. We understand that for most SMEs, internal resources are crucial and need to be prioritised for bidding. By ensuring that we only bid for the most appropriate opportunities, we optimise where and how our clients deploy their resource. As mentioned previously, time is one of the most crucial aspects of bidding for a tender, and too much time and resource spent on a tender could potentially be wasted if you decide to bid without evaluating the impact.
Low win rates
Losing bids result in low win rates. You must analyse and understand where you are in the marketplace. Compliance is just first base; understanding that you have a proposition that could enable you to win is fundamental to optimising win rates. At K Low Consulting, we have a fantastic win rate of 88% and ensure that our clients have the right standing to bid. Before bidding, you should question the following:
Who are our competitors?
Where are we at with the delivery model?
Do we have a coherent strategy in place?
Making the ‘bid no bid’ decision
If you have found a tender that you want to bid on, there are many factors that you should consider before going ahead. At the very basic level, your organisation needs to fulfil the statutory requirements stated within the tender and have the right financial standing. Demonstrating your organisation’s capabilities in your answers, alongside evidence that presents added value, shows that you can deliver the contract requirements.
You must meet all the requirements for the contract. If you meet ‘most’ of the set requirements and not all, you will still lose the bid.
Thoroughly evaluating your standing as an organisation will help you when making the decision. There are many questions that you can ask to come to the right decision, some are:
Do you have an internal or external team in place to help support the bid?
Do you have time and resource to implement the bid?
Can you present added value to the bid, that will make you stand out amongst competitors?
Does the contract fit with your organisation’s strategic growth plans?
Have you completed tenders in the past, and if so, what have you learnt that will be beneficial when bidding for this particular contract?
Do you have the relevant evidenced experience to support your bid?
Are there any factors which would inform the ‘no bid’ decision? If so, what are they?
Is your team equipped to deliver the contract?
Does the contract align with your growth plans?
K Low Consulting’s approach to the ‘bid no bid’ decision
At K Low Consulting, we recognise that the ‘bid no bid’ decision is critical. Our initial consultation with you will outline whether we think you should bid or not, taking the strain and pressure away. We are open and honest with our clients from the beginning of the process, and unlike other tender companies, will not simply encourage you to bid for a tender for profitability. We will thoroughly evaluate your organisations standing and the likelihood of winning a contract. We strive for strong partnerships with our clients and want them to be aware of the best opportunities that align with their organisation’s strategic growth plans.
If you would like our help to decide whether to bid or not for a contract or to find out about our services, please contact us today on info@klowconsulting.com or call 0330 133 1041.
Primary Care Networks are still in the early stages of formation and many people may be unaware or have little knowledge of them.
Primary Care Networks were introduced in the NHS Long Term Plan in 2019 and since then, there has been the beginning of many formations to collaborate healthcare services for the benefit of patients and their healthcare.
Since the introduction of the NHS’s Long Term Plan, practices have organised themselves into their Primary Care Networks as of 15th May 2019 and all except a handful of GP practices in England have come together, resulting in around 1,300 geographical networks (Kings Fund, 2019, https://www.kingsfund.org.uk/publications/primary-care-networks-explained).
Aiming to collaborate a workforce and form a more inclusive work environment to better the needs of patients, the particular challenges, risks and successes of these formed Primary Care Networks can be evaluated.
Questioning ‘are primary care networks a challenging collaboration?’, this article will provide a holistic overview of primary care networks, the potential risks and challenges and finally, the successes.
What are Primary Care Networks?
A Primary Care Network is one or more general practice’s working collaboratively together. This usually consists of networks of doctors and other healthcare providers such as dieticians, pharmacists and nurses.
As stated on the King’s Fund, networks are geographically based and cover all practice within a clinical commissioning group boundary.
It is not a requirement that primary care networks are formed, but if practices choose not to join, they will lose out on significant funding. It’s also important to note that occasionally, a single practice can function as a network if they meet the size requirements. PCN’s will receive funding to employ additional health professionals such as pharmacists and paramedics to enable a greater formation.
Why were Primary Care Networks introduced?
The NHS were facing issues with increased demand in healthcare services. Patients were living longer, with more complex and long-term health conditions. These issues were also coupled with an understaffed workforce.
As a result, the introduction of Primary Care Networks aimed to alleviate the strain on healthcare staff, allowing them to work together to deliver primary care services.
Primary Care Homes (introduced in 2015) were an approach to strengthening primary care. The model brings together a range of health and social care professionals to work together to provide enhanced personalised and preventative care for their local community.
Healthcare professionals were encouraged to work together, in networks of 30,000-50,00 patients, which built on the Primary Care Home model. Following this, in February 2018, refreshed ‘NHS Plans for 19’ was introduced. This plan set out the plans for CCG’s, encouraging every GP to be part of a PCN so that these could cover the whole country as far as possible by the end of 2018/2019.
As part of this contract, the DES announced that PCN’s must appoint a clinical director as their named leader, responsible for delivery. The network agreement states the rights and obligations of the GP practices within the network, how the network will partner with non-GP’s, and a patient data-sharing requirement.
Here are some key legislative dates as mentioned above:
2015: The National Association of Primary Care (NAPC) launched the Primary Care Home model at their annual conference April 2016: NHS England introduced GP Five Year Forward View 2nd February 2018: NHS England introduced ‘Refreshing NHS Plans for 19’ 7th January 2019: NHS Long Term Plan introduced 31st January 2019: GP Contract 2019/20 (outlines what PCN’s will be) 15th May 2019: Practices have to organise themselves into networks and submit signed network agreements to their clinical commissioning group (CCG). 1st July 2019: NHSE expects the network contract to provide 100% geographical coverage
Benefits of Primary Care Networks
As previously mentioned, PCN’s were introduced to allow GP and primary care services to scale up by grouping. As a PCN, workforces can team up to deliver as a larger entity and pull resource where needed.
PCN’s have the potential to substantially improve patient experience. One of the many benefits is that the accessibility of healthcare services increases, allowing them to have access to extended services.
In terms of other benefits, each PCN will encounter their own set of benefits individually. As provided below, success stories present two different sets of benefits for patients and staff.
Examples of these benefits as outlined in the success stories are:
Better work relationships and collaboration
A stronger focus on patient care and experience
Easier to identify key issues within the community through collaboration
As health.org.uk and Nuffield Health outlined, there are a particular set of risks and challenges associated with PCN’s:
1. Speed
One of the most prominent risks of PCN’s is the speed of implementation of these collaborations. With such a tight set of deadlines associated with PCN’s, it may be difficult for people to familiarise themselves with PCN’s and then form their practices into networks within these time restraints.
As Nuffield Health illustrated, these tight deadlines could mean that failure was inherent form the policy design. It could be said that these timescales are unrealistic and ambitious, not giving professionals enough time to adjust to the rapid changes.
2. Funding
In terms of deciding not to join a network, practices will miss out on the sources of funding. However, even if there is a formation of a PCN, there is a risk that there will be a removal of other sources of income for practices.
In addition to this, NHS England has promised to meet 70% of costs of employing most additional staff need for the PCN, meaning networks must cover the remaining 30% of the cost associated with this. This could be particularly costly for those practices that cannot afford this.
3. Workforce and workload
A particular risk associated with PCN’s is that they may decrease the amount of GP time available.
Additionally, there is no proof that the NHS is supplying 20,000 additional health professionals as stated in their plan. Increasing this workforce also means accommodating for these new staff members, which may pose a particular challenge for some GP’s where workspace is limited.
There could be a lack of operational support to realise the amount of PCN roles that need to be filled in this short time period. Additionally, some practices may not have the funding available to appoint new staff members.
4. Lack of collaboration
There is a risk that PCN’s may not be able to form effective organisations.
The knock-on effects of the lack of collaborations between practices are that there are disputes which could result in isolation and resist, creating further issues amongst networks. Thus, this could result in a lack of collaboration and the failure of an effective network model.
As stated on the King’s Fund website, the research found that collaboration in general practice was most successful when it had been generated organically over several years and if it was reinforced by trust, relationships and support. On the other hand, research has shown that a lack of clarity of purpose and engagement or over-optimistic expectations resulted in less effective collaborations. This suggests that collaboration and focus should be coupled together to form an effective PCN.
5. Lack of focus
There are a large number of objectives for PCN’s. The number of objectives that professionals must fulfil, may be unrealistic and put further pressure on them.
In 2020/21, there are five out of seven service specifications expected to be delivered. This heightened pressure on healthcare professionals may result in intolerable pressure resulting in a lack of focus.
Protecting Risks and Challenges of Primary Care Networks
Although, as Primary Care Networks are still in the early stages of development, these risks and challenges could be easily rectified at this early stage.
Nuffield Health provides a series of possible solutions to these problems, some of which are provided as examples below:
Issue: Lack of collaboration/ not able to create effective organisations
Possible Solutions:
Create a new vision for primary care: defining what an effective PCN looks like and what can be achieved.
Carve out time (using paid backfill, ideally from CCG’S/STP’s) to build a shared organisational vision
Draft vision statements as practical documents
Create clear roles for each of the different levels of the local system
Issue: Lack of focus
Possible Solutions:
‘Work with CCG’s and commissioning support units to undertake multi-level approaches to tackling population health and general operations’
‘share learning across practices and governance levels in a neighbourhood to create a sense of shared ownership’
Issue: Speed
Possible Solutions:
‘Policymakers should acknowledge that an organisational plan can take up to two years, and outcomes 5-10 years to realise’
‘STPS/ICSs and CCGs should work closely with PCNs to agree roles, responsibilities, development plans, timelines and funding arrangements until 2025’
‘PCNs leads and practice liaisons should jointly agree on the purpose of new roles and their contractual terms and conditions’
‘CCGs should examine where their management support should be best placed- this role has had little attention to date in primary care workforce planning and funding’
Issue: Workforce/ Workload
Possible Solutions:
‘create a shared physical space for the PCN and bring people together during their working day to talk about what they want to achieve’
‘help clinical directors to improve the capacity and capability of their network by focusing initially on small, achievable initiatives that help or reduce workload in individual practices and build trust’
‘Appoint leaders who have skills to make sense of the environment and set the direction, as well as managing the many different aspects of the organisation’s functions’
Successes of Primary Care Networks
Despite the foreseeable risks and challenges to PCN’s, there have been a number of success stories which illustrate the impact that they have already made.
They sought to identify the problems that their patients had and work towards rectifying these issues as a PCN. One of the issues identified was that they had a considerably high percentage of older patients and they had to be attentive when caring for those patients, especially those who were on a terminal decline. Thus, they appointed a care co-ordinator and benefitted from the PCN team across the network.
Alongside this, a Parkinson’s nurse was appointed, a partnership with the York Teaching Hospital has been formed and a rapid cancer diagnosis pathway is underway.
Dr Evans, one of the doctors in the Yorkshire Primary Care Network stated: “The care of our patients is a lot more organized and anticipatory, and [there is] less crisis. But actually, more important, it works”
There has been a substantial impact of this PCN, details of such are as followed:
‘They have been identified by an independent audit on behalf of NHS England as an exemplar of best practice’
‘They use a 0365 platform to share project information and documentation. This has provided visibility of project progress and support collaborative and agile working in the absence of shared file arrangements- dedicated programme support’
‘Dedicated programme support has enabled the work to move at pace, providing a structure for everyone to feed into and embrace’
‘CSU expertise within the programme management provided valuable support in sharing best practice across the network, using case studies to support current and future opportunities in collaborative working’
‘created a robust governance structure has enhanced working relationships and provided visibility and clarity on roles and responsibilities across the network’
Their shared vision is: “Working together to deliver high quality, innovative and sustainable healthcare for our community with commitment, compassion and integrity”.
Successes of Primary Care Networks: Self Evaluation for Staff
As exemplified by the National Association of Primary Care, Figure 2 presents the outcomes of a questionnaire for staff. It shows the self-assessment by PCN supervisors, of how networks have improved the workplace. As shown, there is a lower demand for primary health services and patients are engaging more and benefiting from healthier lifestyles.
Figure 5 (as presented on NAPC.co.uk) also presents that improved self-management, healthier lifestyles and patient engagement has increased pre vs. post PCN.
Contact Our Team Today
If you need help on a tender, contact our experienced team of writers today on 03301 1331 041. Alternatively, send an email to info@klowconsulting.com for more information and details.
This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.
Strictly Necessary Cookies
Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.
If you disable this cookie, we will not be able to save your preferences. This means that every time you visit this website you will need to enable or disable cookies again.
3rd Party Cookies
This website uses Google Analytics to collect anonymous information such as the number of visitors to the site, and the most popular pages.
Keeping this cookie enabled helps us to improve our website.
Please enable Strictly Necessary Cookies first so that we can save your preferences!
