Getting started

Establishing core principles

The PCN should adopt the four core principles below when developing its new Modern General Practice access model and how they can be applied in practice.

Principle 1: Co-production

The design and development of the hub operating model and technical solution must draw on close collaboration between the PCN and its constituent practices. A series of workshops should be held to explore the available baseline data, define the problem statements, and appraise the different options. The principles of co-production and collaborative working should be maintained throughout the project’s development, with senior representatives from each practice forming an executive board overseeing its progress.

Principle 2: Equity

As well as triaging and administering patient services centrally, the new PCN hub operating model should offer additional “overflow” appointments delivered by PCN clinicians into which all practices (and staff working in the hub) can book their patients. A second key principle is therefore equitable access to this shared resource so that all PCN member practices could access a fair share of this additional capacity. This principle should be supported by regular and transparent reporting that show how much each practice is utilising hub resources. This will help out to iron out any early inconsistencies in terms of allocations across the network.

Principle 3: Sustainability

It should also be agreed that the solution needs to be financially sustainable and achievable with the available workforce, this will strongly influence planning decisions. The affordability of the new model for example, may be depended, in part, upon taking the decision to establish it as a nurse practitioner-led service, rather than a GP-led model. The PCN also may also decide to invest some of its own surplus funds to pay for a Digital Transformation Manager and Project Manager at the outset of the project, although the former is now fully funded within the ARRS.

Principle 4: Agility

Finally, the project should be built with a shared recognition that the challenges facing the PCN would require a highly iterative and agile approach. The core functionalities provided by the technical solution will create opportunities to expand the range of services that could be supported by the hub. As a result, the hub’s operating model may in the future incorporate other PCN-delivered services.