Local NHS changes: introducing the East Kennet Primary Care Network
The latest change to the organisation of the NHS at the local level is the creation of Primary Care Networks. In April we reported the general ideas behind this new initiative.
This month the Primary Car Networks (PCNs) have officially come into existence and started work - so we can now report on the one covering the Marlborough area and beyond - the East Kennet PCN.
East Kennet PCN is made up of four practices operating over six GP surgeries: Marlborough and Pewsey (since April 2017 joined together as the Kennet and Avon Medical Partnership - KAMP), Ramsbury and Wanborough, Old Schoolhouse Surgery in Great Bedwyn and the Sprays Surgery in Burbage.
These surgeries have been co-operating for many years - especially working with the community nurses and sharing expertise. The PCN formula puts this co-operation on a formal footing under a 'network agreement'.
The minimum size for a PCN is 30,000 registered patients. East Kennet's list of registered patients stands at 34,090 - making it the fourth smallest of the eleven PCNs covering the county.
GP surgeries were not required to join a PCN, but joining brings new funding to help extend the services surgeries can provide for their patients.
It is important to realise that this funding is not to bring more GPs into a surgery (if they could be found). It is aimed at taking pressures off GPs - so getting patients seen and treated faster by a health care specialist or support worker.
In the first year there is full funding for each PCN to employ a Social Prescriber and 70 per cent of the costs of employing a Clinical Pharmacist. And these posts will be advertised quite soon.
The way the funding is being distributed among PCNs means that the smaller ones will benefit the most. But they are likely to be in more rural areas. And this does bring the problem of how best to use these new health professionals. To lessen the time they spend driving from surgery to surgery, it may be best to employ two part time staff.
NHS England has decreed that each PCN must have a Clinical Director - usually one of the GPs. These are not paid posts, but the new funding will cover GPs replacement when they have to attend meetings away from their surgeries.
However, as three members of the East Kennet PCN are smaller scale surgeries and it is difficult to find locum replacements doctors at short notice and for single days, they have decided their Clinical Director will be a three-way job share 'to reduce the impact on any one practice'.
The three sharing the role for East Kennet are GP partners Dr Anne Woods (Bedwyn), Dr John Williams (KAMP) and Dr Graham Muller (Ramsbury). On the administration side the PCN will be run by Mike Farmer (KAMP's Business Manager) and Alison Harrod (Ramsbury's Practice Manager).
As Dr Woods explained to marlborough.news: "The Clinical Director is notionally responsible for the success of the network. There has to be a figurehead - we've just got three figureheads."
The role of Clinical Pharmacist was introduced to Scotland's NHS in the 1990s and they are now well integrated with Scottish GP practices. For PCNs in England they will carry out medication reviews and triage services. KAMP recruited its own Clinical Pharmacist earlier this year, and is already seeing benefits for patients.
Right now East Kennet are deciding whether this role will be filled by two part-timers and which surgery will employ them. Will they be able to fill this post? "We are aware of people interested in the job."
The Social Prescriber is a coordination role - 'to make sure a patient has a good journey through their treatment'. They can be a non-medical person "Looking at broader, non-medical aspects of a patient's general care needs." More about wellbeing and helping the prevention of illness.
In Wiltshire the PCNs are the responsibility of the Clinical Commissioning Group (CCG). Quite how that governance role will develop once Wiltshire CCG has merged with Swindon and Bath & North East Somerset CCGs remains to be seen.
Each practice in East Kennet will continue to work with its Patient Participation Group - and these Groups are now mandatory as part of the recent changes in primary care.
The PCNs have five years to develop and make the necessary differences for patients and doctors. As one senior doctor on the Wiltshire CCG said recently: "They're only just walking - so we can't expect them to run just yet."
Illustration above shows - clockwise from bottom left: Ramsbury Surgery, Marlborough Surgery, Old Schoolhouse Surgery (Great Bedwyn), The Sprays Surgery (Burbage), Pewsey Surgery.