It may seem impossible .....

It may seem impossible to think about in our current situation, but at some point the crisis that is Covid-19 will end, and life will return to what we know as normality.

Whilst those with whom we work in primary care are focused almost solely on dealing with the Pandemic, we are finding the Clinical Directors also know that the PCN DES is continuing and are keen to ensure that momentum gained to date is not lost.

To that end we are supporting our clients by continuing to work on the requirements of the DES and in so doing, enabling them to focus on managing the Pandemic both in their own practices and across their Networks.

1. Use of Funding Streams

We will look at the various sources of income available to your through the DES and work with you to understand the areas of pressure along with your plans and priorities, and put proposals forward for use of that funding. Our approach will ensure that funds are used to maximum and best effect in support of the Network.

2. Completion of Schedule 7 of the MNA

We have experience of developing integrated models and working, and will support your Network to engage with Community and Mental Health Providers along with Community Pharmacy to establish how to work constructively and collaboratively together, and in so doing ensure completion of Schedule 7 of the MNA.

3. Delivery of Service Specifications

We will support you to establish how best to deliver the requirements of the specifications for Structured Medication Reviews and Enhanced Health in Care Homes starting in October, as well as commence work on Early Cancer Diagnosis. In respect of EHCH in particular, we have been involved in a successful pilot of a scheme that delivers the requirements of the specification and will share our learning in that respect.

4. Additional Roles Reimbursement Scheme and Workforce Planning

In terms of the Additional Roles Reimbursement Scheme (ARRS), our approach is to support your Network to develop the required workforce plan by having a strategy to ensure that the funding available for new additional roles is used in its entirety and to best effect. Our recommended and innovative approach to this has three elements, with the funding available split into three parts, or budgets, in proportions that reflect the position of your Network, as follows:

Budget 1:

Where your Network has already agreed some of the roles that you wish to recruit to, or have recruited to, we work with you and other key stakeholders (for example, GP Federations and NHS Trusts) to find the best and most effective way or recruiting to those roles and ensuring the clinical and supervisory support is in place.

Budget 2:

Given that there are new roles that have been added to the original list of reimbursed roles Networks are not always yet clear which are going to be of most benefit to the Network and to patient care.

On that basis, and to inform strategy, we will support you to take on staff on a temporary and flexible basis in order to try service options before making final decisions regarding permanent recruitment. Generally, these temporary staff will be engaged via agencies, which will cost more than the reimbursement available, but the view is that this is a worthwhile exercise in order to make best use of resource in the long term and ensure that new clinical staff are recruited who will optimise patient care and reflect the skill mix needed across the Network. As this is a short-term trial, funding from such as the £1.50 per patient can be used to make up the shortfall.

Effectiveness and value of the temporary roles will then be assessed using such as PDSA (plan do study act) and the outcome then used to inform recruitment to permanent roles going forward.

Budget 3:

This is a pot of funding that is split and available pro-rata across the Network practices to enable them to recruit to roles that perhaps not all practices across the Network may wish to recruit to. Practices may do this individually, or work with other practices in the Network to make joint appointments.

By offering and taking this flexible approach, this enables your Network to make best use of the funding available for your Network as a whole, the individual constituent practices and for the population that you serve.

Scott McKenzie is an independent management consultant supporting GP Practices, GP Federations, Primary Care Networks of 30k-50k structure correctly to then deliver high quality patient outcomes with financially viable solutions. Scott is working to support the Pharma, Med Tech and Device Companies better engage and access the NHS. For more information on how we can support you please contact Frances on 0845 388 0302 or email

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