• Primary care reforms must deliver on three “real world” tests, says Simon Stevens
  • Tests address access, workforce, and nursing teams

Simon Stevens has identified three top “real world tests” for primary care networks.

The NHS England chief executive said improving access, addressing workforce pressures, and joining up primary and community nursing were the three main asks.

The specifications for PCNs – of which about 1,200 were formed to cover England earlier this year – are set out formally in a contract agreement with the British Medical Association.

However, Mr Stevens said: “The real world test will be, first of all, have they helped with some of the workforce challenges in the constituent GP surgeries that form them.

“Things like sharing the extra primary care professionals that are being partly funded now, whether it’s clinical pharmacists or therapists, [or] other disciplines that can’t always be deployed at practice level. Are they helping GPs and sessional GPs work across practices? So PCNs need to be an organising entity for that type of workforce support.

“Secondly, from the point of view of patients, are PCNs improving patient access to appointments at their GP practice? As well as workforce, there are a set of things around practice organisation and systems that [PCNs] can help with.

“Then the third thing is PCNs helping link primary care and community nursing teams. With around 1,000 primary care networks for 30-50,000 people you now can make a reality of team assignments for the patients that community teams and practices are going to support jointly.”

Speaking at HSJ’s Integrated Care Summit in Manchester last month, Mr Stevens stressed that, in relation to access, PCNs should be able to coordinate various contracts and funding streams better. These might include dedicated extended-hours funding, out of hours primary care, 111, and other urgent care services. 

“So-called extended access [is] often organised differently down different funding streams, with different providers in different parts of the country,” he said. “And that is not integrated urgent care of the sort we want.

“So, we are expecting PCNs to begin to manage those integrated funding streams and to bring coherence to what that urgent care offer looks like.”

More than a quarter of respondents to the latest GP patient survey, released in July, said they had waited a week or more for an appointment with their doctor, an increase from the previous year’s survey.

NHS England’s director of primary care, Nikki Kanani, is carrying out a review of GP access that is expected to report this month. One goal of Dr Kanani’s review is to find a way to improve patient reported access and reduce variation in waits.

It will also support NHSE’s efforts to simplify and streamline urgent and emergency care outside of hospitals. Various existing funding streams for extended access GP services will be rationalised into a single payment system to PCNs.

They will provide convenient in-hours appointments and better integration between NHS 111, urgent treatment centres, and general practice.

Mr Stevens was speaking at HSJ’s Integrated Care Summit in Manchester. The event is held under the Chatham House rule. However, Mr Stevens consented to the above remarks being used on the record.