• More clinical leadership will ‘turbocharge’ network development
  • Will help with workload in the first year of network development
  • Funding is drawn from the GP Forward View and exists only for the next 12 months

Commissioners in the East Midlands are hiring deputy directors to support the clinical directors leading its primary care networks.

Nottingham City Clinical Commissioning Group had set aside funds from the GP Forward View to pay clinicians to work one session a week supporting the new accountable leads for the area’s eight PCNs.

Clinical directors are drawn from the members’ practices in the PCN, which they lead, and are accountable to its members.

A key aspect of the director’s work will be representing their PCN in other networks and health providers in their local area as well as represent their PCN in the wider integrated health system.

The five-year network agreement includes funding to pay the clinical directors to work two sessions a week, or eight hours, on that role.

Nottingham City CCG believed the workload would be substantial, especially in the first year of the contract, and has decided to fund a deputy role to share some of the workload, as well as a way to support younger GPs move into clinical leadership roles.

“There’s going to be a lot of work to do getting PCNs really firing on all cylinders,” Hugh Porter, chair of Nottingham City CCG, told HSJ. Both in terms of “practices working together but [also] really starting to work with the other health and care partners and the voluntary sector; starting to think about population health management.”

“It’s a big ask to get that really going quickly so extra clinical leadership, we thought that would turbocharge that development,” he said.

The expectations of wider engagement with other health and social care providers kick in year two of the five-year contract. NHS England and the British Medical Association, who negotiated the contract, have said the first year should be focused on building relationships within the network, between its GPs and other clinicians.

In Nottingham City, primary care has been working in a similar vein to PCNs since at least 2015 with GP practices operating in care delivery groups. Last year, the CCG decided these bodies should have clinical leaders, Dr Porter said.

They found funds to pay for the role in the GP Forward View’s resilience fund, which provided £40m until 2020 “to support GP practices and to build resilience into the system”.

“It is a year’s post,” Dr Porter explained. “The thinking is, if it’s very successful PCNs might choose to fund it themselves going forward,” depending on the outcome of a year-end review.