This document outlines a step-by-step approach to setting up a new Primary Care Network (PCN) Clinical Hub, drawing on the lessons and best practices from the Folkestone, Hythe, and Rural PCN Hub Pilot Project. The aim is to create a sustainable, equitable, and efficient model for delivering enhanced primary care services.
1. Vision and Objectives
The primary goal of the PCN Clinical Hub is to improve access to primary care services by:
- Ensuring patients receive timely, equitable, and high-quality care.
- Expanding appointment capacity and managing demand peaks effectively.
- Delivering a range of enhanced services through a centralised hub model.
2. Core Principles
The following principles should guide the development of the Clinical Hub:
- Co-Production: Collaborate with all stakeholders, including member practices, patients, and staff, to design and refine the model.
- Equity: Ensure fair access to hub resources across all practices, supported by transparent reporting.
- Sustainability: Design a financially viable model that leverages existing workforce and funding streams.
- Agility: Build a flexible infrastructure that can adapt to changing needs and support new services.
3. Key Components of the Hub Model
The Clinical Hub should include the following elements:
- Online Consultation Hub (eHub):
- Centralised triage and processing of online consultations.
- Clear workflows for signposting, clinical triage, and administrative tasks.
- Defined operating hours and business continuity plans.
- Enhanced Services:
- Minor Illness Hub led by Advanced Nurse Practitioners (ANPs).
- First Contact Physiotherapy, Mental Health Practitioners, and Care Home Teams.
- Additional services such as spirometry, dietetics, and social prescribing.
- Technical Infrastructure:
- Single sign-on for seamless access across practices.
- Integration with clinical systems for prescribing, test requests, and patient record updates.
- Use of accredited third-party abilities for messaging and online consultations.
4. Implementation Steps
- Engagement and Planning:
- Host workshops with member practices to define objectives and address challenges.
- Engage with patient participation groups (PPGs) to gather feedback and ensure patient-centred design.
- Baseline Assessment:
- Analyse current access models, online consultation volumes, and response times.
- Identify gaps in clinical systems and areas for improvement.
- Service Design:
- Define the scope of services, inclusion/exclusion criteria, and referral pathways.
- Develop Standard Operating Procedures (SOPs) for consistent delivery.
- Workforce Planning:
- Recruit and train staff, focusing on digital transformation and clinical governance.
- Use historic data to model resourcing needs and ensure capacity meets demand.
- Technical Setup:
- Configure systems for appointment booking, task management, and data sharing.
- Ensure compliance with clinical safety standards (e.g., DCB0129/0160).
- Pilot and Refine:
- Start with a phased rollout, gradually adding services and staff.
- Use feedback and data to refine the model and address any issues.
5. Governance and Sustainability
- Establish a governance structure with representation from all member practices.
- Monitor utilisation and performance through regular reporting.
- Leverage NHS funding streams, such as the Additional Roles Reimbursement Scheme (ARRS), to support the hub.
6. Future Expansion
- Build flexibility into the hub model to support new services, such as Acute Respiratory Infection (ARI) hubs or administrative support for online consultations.
- Explore opportunities for collaboration with neighbouring PCNs and system partners.
7. Checklist for Success
- Engage Stakeholders: Map out all relevant stakeholders and involve them early.
- Define Objectives: Clearly articulate the problems to be solved and the desired outcomes.
- Invest in Skills: Recruit or train staff with expertise in clinical environments and digital transformation.
- Build Strong Foundations: Develop robust project management, clinical governance, and training frameworks.
- Leverage Funding: Take advantage of available NHS resources to support the model.
- Monitor and Adapt: Use data to continuously improve the hub’s performance and expand its capabilities.
This blueprint provides a comprehensive framework for establishing a PCN Clinical Hub, ensuring it is patient-centred, sustainable, and adaptable to future needs.
Digital PCN HUB Optimisation 