From 1 July 2019, all patients in England should be covered by a primary care network (PCN). PCNs are made up from groups of neighbouring general practices. New funding is being channelled through the networks to employ staff to deliver services to patients across the member practices. PCNs are not new legal bodies, but their formation requires existing providers of general practice to work together and to share funds on a scale not previously seen in UK general practice. The hope of national NHS leaders is that PCNs will improve the range and effectiveness of primary care services and boost the status of general practice within the wider NHS.

PCNs are being introduced at a very difficult time for general practice. The NHS long term plan acknowledges that investment in general practice declined relative to the rest of the NHS between 2004 and 2014, while both demand and complexity of patient needs were rising. This has contributed to a fall in patient satisfaction and increased pressure on staff, which has exacerbated shortages of GPs and practice nurses, who have left the profession at a faster rate than it has been possible to replace them. Despite a target to increase the number of GPs by 5,000 between 2014 and 2020, the number of full-time GPs was 6% lower in 2018 than in 2015.

PCNs will receive funding to employ additional health professionals such as pharmacists and paramedics. Once they are established, The NHS long term plan envisages that the networks will also be a vehicle for improvements in primary care and broader population health, and give primary care more influence within the larger Integrated Care Systems (ICS) – geographically based partnerships of NHS organisations and local authorities – which will be in place across England by 2021.

PCNs are being established rapidly at a time when general practices have limited spare time and energy to invest in creating new networks. Formally announced in The NHS long term plan on 7 January 2019, the vision of what PCNs would be, and what they might be expected to do, was outlined in the 2019/20 GP contract published on 31 January 2019. Details of the funding (how much PCNs will receive and what is expected of them in return) were published on 29 March 2019. Practices had to organise themselves into networks and submit signed network agreements to their clinical commissioning group (CCG) by 15 May 2019. NHS England expects the network contract to provide 100% geographical coverage by 1 July 2019.

Joining a PCN is not compulsory for a GP practice. But by channelling a significant proportion of the increased funding for general practice – £1.8bn of the £2.8bn promised over 5 years in The NHS long term plan – through the network contract rather than directly to individual practices, NHS England has made it challenging for practices to abstain from joining PCNs.

This briefing places PCNs in the context of previous changes to general practice funding and contracting. It examines the rationale for networks, explores relevant evidence and draws out intended benefits and possible risks for the future of PCNs.