General Practice continues to face challenges from many directions: workforce challenges, the challenges of increasing demand and the challenge of ensuring general practice remains a financially viable entity in the system coupled with the challenges inherent with the expectations of working collaboratively across practices and wider neighbourhoods.
The phenomenal response from networks to the challenges of delivering around a 20% increase in capacity over the capacity they were delivering pre-covid pandemic shows how collaboration can have a huge impact, but with the benefits of collaboration come potential risks.
Many PCNs are looking at incorporation as an approach to mitigate some of the risks inherent with working at scale as a PCN. As a result, at SCW we are now being asked to support PCNs with incorporation; creating a legal entity Limited Company to manage the functions of the PCN. While this was not envisaged in the NHS Long Term Plan, it is fast becoming one of the top requests for support we receive.
As with most things in life, there are advantages and disadvantages.
Advantages of this approach include that the company will be a separate legal entity that affords limited liability to the member practices, who will own the business. The company could employ the staff for the PCN, including the additional roles, rather than having this handled by a lead practice or another local provider. Many envisage that, with a separate legal entity, they will secure better engagement and a more cohesive approach as they will be running a business, something that has its own identity.
In addition, a GP federation offers scale to general practice and provides the opportunity for it to have a single voice of strength across a whole health economy. This in turn provides the opportunity for the voice of primary care to be heard as Integrated Care Systems mature.
The disadvantages may include pension approaches where employing the staff. Attracting the right staff may require the company to be able to offer the NHS Pension scheme. Achieving this will require the company to hold a qualifying contract. This then becomes about the willingness of commissioners to support you to gain that qualifying contract. This may be easier to achieve with the scale afforded by a GP Federation supporting a number of PCNs.
Another key item is how you fund the company and associated running costs. The PCN doesn’t deliver core contract and therefore has limited income-generating opportunities. The PCN funding of £1.50 doesn’t go far, which may leave practices having to look at how they deliver further funding. Alternatively, the PCN may want to explore alternative income sources to remain viable, e.g., hospital subcontracts and or ICB commissioned services.
If you can already see the benefit from active support to become a business-ready PCN or federation, with fully engaged practices capable of remarkable delivery, we would be delighted to show you how you can quickly achieve this.
Within SCW we have a highly successful track record of supporting practices to come together to develop their limited liability company. Our approach provides the opportunity for practices to explore what would work best for them. We draw upon best practice using unique approaches to develop the company model. Beyond initial development, we provide support with writing business plans, developing proposals for negotiation and with negotiation approaches to ensure the ideal outcomes are achieved.
Our client base secures excellent outcomes through the combination of a process-led approach underpinned by strong implementation.
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The Primary Care Team in SCW provides support and direction to practices, Primary Care Networks and federations to successfully implement new care models, develop connections and work collaboratively within Integrated Care Systems.
We aim to enable health and care systems to achieve the best possible outcomes for people, communities and populations.
For more information on our support packages, or for any questions,
