ICBs should plug any funding gaps for PCN development that were lost in the transition from CCGs, the NHS Confederation has suggested.
Primary care members of the unitary board of the ICB should also be trained and remunerated to ensure parity with other members, it said.
It comes as part of a major report marking three years since the networks were established in July 2019, during which time PCNs grappled with the Covid pandemic, followed by the dissolution of CCGs and restructure around ICBs.
As a result, PCNs have struggled to work through an ‘unstable operating environment’ and amid uncertainty surrounding their future beyond 2024, despite their role as ‘the foundation’ of ICSs.
It said: ‘With primary care being the foundation – and PCNs being the building blocks – of ICSs, it is vital that all future policies are designed with primary care as the starting point. Not only will this have the greatest impact, as primary care accounts for 90% of all NHS activity thus creating a higher yield, it will also aid integration and delivery of NHS Long Term Plan objectives.’
According to the NHS Confederation, the dissolution of CCGs has removed ‘much-needed back office support’ for PCNs and the loss of place-level support, while also eroding relationships with the greater system.
And the lack full coverage of federations or of recognition from system partners has led to ‘a vacuum of planning and support at place level’ between PCNs and the ICB.
‘Systems must invest in both hard and soft infrastructure for primary care, helping them to both accommodate and support their workforce, gain an in-depth understanding of their population’s health needs, and aid integration,’ the Confederation said.
It called on ICBs to engage primary care in system plans and to release funds to primary care within reasonable timeframes.
The Confederation also warned that building primary care leadership capability is vital to improving place-level integration, urging ICBs to include PCN clinical directors wider system development opportunities.
It also urged systems to work with primary care to evolve PCNs into integrated neighbourhood teams – one of the key recommendations from the NHS England-commissioned Fuller Stocktake report in May.