A primary care network (PCN) that developed its own neighbourhood boundaries was left concerned that proposals to split PCN and practice boundaries across multiple footprints could ‘rip up’ local relationships.
Whitewater Loddon PCN begun drawing up its own neighbourhood boundaries because waiting to be told what was happening was leading to ‘fear’ over what any plans might look like.
Its manager and digital transformation lead Liz Mayon-White said that the PCN had drawn on the relationships it had built with partners across secondary and community care, councils, pharmacists and the voluntary sector, and aligned its own neighbourhood with the existing Whitewater Loddon boundary.
But she said the PCN was then left concerned by Hampshire and Isle of Wight Integrated Care Board (ICB) proposals that split PCN geographic areas and practices boundaries into multiple neighbourhoods.
The PCN said this would have resulted in the ‘ripping up’ of relationships that took years to build.
Ms Mayon-White added: ‘For six years now, we’ve been working to build relationships between our practices, within secondary care and with pharmacies.
‘We couldn’t imagine why anyone would anyone upset those relationships now and redraw geographical boundaries to turn them into something else.’
‘Alongside our efforts, it seems that the system was also experimenting with their own boundaries,’ she added. ‘But what resulted was a dissection of not only PCN geographical areas, but in fact, in some cases, chopping up individual practices boundaries into perhaps two or three different neighbourhoods.
‘Even within our own PCN, one practice was to be split across two separate neighbourhoods. In doing so ripping up relationships that we’ve worked hard to build, over the past six years.’
However, she said the PCN was now ‘delighted’ that the ICB had taken feedback from PCNs and redrawn proposed boundaries to align much more closely with current PCN boundaries.
She added: ‘I think the question still remains: who makes this final decision and, since we will be the ones implementing this, how can we influence that?’
Hampshire and Isle of Wight ICB told Healthcare Leader that no final boundaries have been confirmed yet.
Its director of neighbourhood health James Roach said the ICB was waiting for further national guidance, including around future contractual arrangements, but was committed to working closely with practices, PCNs and wider partners.
He added: ‘We recognise the importance of getting neighbourhood health boundaries right and understand the strength of the relationships that have been built locally between primary care, community services, councils, voluntary sector organisations and other partners.’
Mr Roach said that the ICB had undertaken extensive engagement with local partners, including PCNs, and shared proposed neighbourhood health areas for feedback.
‘These proposals were intended to support discussion and gather local insight, using available data and cross-system mapping alongside the knowledge and experience of those delivering care locally — they were not final decisions on boundaries,’ Mr Roach added.
‘We have heard clearly from partners about the importance of ensuring neighbourhood footprints reflect existing relationships, population needs and the way services are delivered. We are considering this feedback carefully and will continue working collaboratively to refine arrangements.’
A version of this article was first published on Healthcare Leader’s sister title Pulse PCN.
