The PCN has worked closely with practice managers, GP partners and other key operational and clinical leads to define and deliver the new hub operating model.  This process was shaped by a delivery roadmap, which prioritised how and when additional services could be added to the PCN function – all were supported by standard operating procedures that were developed for all hub-based services.    

The PCN hub now delivers the following services on behalf of its local practices:

Online consultations  

A single, centralised team receives and processes all online consultations received across the PCN’s seven practices, which are filed and coded into the patient record. All clinical online consultations are triaged, and those that are suitable for management by a PCN-level service are then passed onto the relevant team via the digital platform. At present, the hub can manage between 30 to 40 per cent of all clinical online consultations itself, without having to pass any work back to the patient’s local practice.

Minor Illness service

The Minor Illness service offers both remote consultations and face-to-face appointments where necessary. The service provides additional appointment capacity from a team of dedicated prescribing Advanced Nurse Practitioners operating within the hub. This is a six-day a week service that is aligned to the PCN Network DES Enhanced Access requirements. It was designed in response to historic audits that showed that around 30 per cent of inbound clinical demand into local GP practices was due to a minor illness problem. The inclusion and exclusion criteria were set by the PCN management team based on the scope of practice of their prescribing Advanced Nurse Practitioners.

General Practice Community Pharmacist Consultation Service (GP CPCS)

While practices were already able to refer patients from their own clinical system into community pharmacy services, the new functionality developed during this pilot now allows PCN hub teams to do the same: in effect, this allows PCN staff to complete system-to-system GP CPCS referrals and also provides a direct line of contact back to the hub from the community pharmacy to improve communication between teams.

Other Enhanced Services

The hub operating model also supports the delivery of PCN-level services. These include Enhanced Access hours provision, Enhanced Health in Care Homes, multi-disciplinary team case management, and other services delivered using ARRS-funded staff — all of which have been enabled through the improvements in IT infrastructure and the new operating model.

“The new access model supports the practices by assessing the patient’s needs and connecting them to the most appropriate PCN-level service using ‘right care, right time, right person’ principles. It has helped our network to move away from a demand-led approach to a more holistic and needs-based service for its patients.”

Dr Aravinth Balachandran, Clinical Director, Folkestone, Hythe and Rural PCN

Next section: Overview of the technical solution