One of the principles that shaped the design and scope of the hub was that it needed to be achievable and realistic for its workforce to deliver. The PCN worked closely with its delivery teams to create an operating model that supported their professional skills and experience while also bringing in the additional expertise necessary to design and embed the technical solution. The hub has also helped to improve the working experience of PCN staff, supporting greater collaboration between hub and practice staff and creating a stronger “one team” ethos. 

The core hub workforce 

PCN initially recruited three Advanced Nurse Practitioners, who were trained on how to review and handle online consultations, manage triaging and referral processes, and provide remote and face-to-face appointments for patients with minor illnesses. A fourth lead nursing practitioner has since been recruited to oversee the team. They are supported by two Care Coordinators, who help with processing of online consultations and communications with patients.

As new capabilities were added into the hub’s IT systems, the range of professionals brought into the operating model expanded to include other ARRS-supported roles within the PCN. The wider team now includes: a Physiotherapist, a Lead Pharmacist, a Clinical Pharmacist, pharmacy technicians, a Specialist Cancer Care Co-ordinator, a Paramedic Practitioner, a Social Prescribing Link Worker, and an Occupational Therapist. It also draws in other non-ARRS support, including the work of care home nurses and healthcare assistants employed by the PCN.

The senior management team

Recognising the importance of digital and change management expertise, the PCN also invested in a management team to support the hub’s development. This included an Operational Manager, Digital Transformation Manager and Project Manager, who have all played a pivotal role in building and embedding the new hub operating model.

They report into an executive board led by the PCN’s Clinical Director and involving senior representatives from each of the other local practices across the network. The board is responsible for strategic oversight and direction.

Staff training and development

Clinical training for the new hub-based nurse practitioners was led by the PCN’s Clinical Director and the wider clinical team within the PCN lead practice. This included intensive training on reviewing and handling online consultations, understanding the criteria and thresholds for offering minor illness appointments and ensuring standard operating procedures were followed.

In addition, all staff who would be booking in patients through the hub, whether they worked in the hub itself or at one of the local practices, received training on how to use the new systems to ensure they understood the new tools and followed consistent processes by the Digital Transformation Manager and the Digital Project Manager.

The hub delivery team has weekly meetings with the PCN leadership team to discuss operational issues, review cases and learning, and advise on how the operating model might be refined based on their experiences and feedback.

Staff testimonials

“Seamless access to clinical systems and IT hardware has made our work more efficient and enjoyable, which has boosted staff morale and created a more supportive and pleasant working environment. The hub has also revolutionised our work dynamics and collaboration, improving communication between teams and increasing clinical contact time with patients.”

Sumin Moses, Extended Scope Physiotherapist, Folkestone, Hythe and Rural PCN 

“Our productivity has soared and patient feedback is extremely positive, as the hub’s Minor Illness team can now normally complete an episode of care the same day, either by telephone call, face-to-face consultation or remote closure by way of advice or prescription. This has truly transformed the way we operate.”

Alison Hothersall, Lead Advanced Nurse Practitioner, Folkestone, Hythe and Rural PCN 

Next section: Governance, funding and compliance arrangements