I thrive on listening to new voices and seeking out fresh perspectives and recent conversations with a number of GP’s I’ve connected with here have really challenged both my experiences of the last five years and some of the beliefs I’ve developed as a result.

PCNs are the funding focus in general practice, and since their formation in 2019, I’ve observed that Clinical Directors (CDs) tend to be strong proponents of the PCN model. While there’s variation, most CDs I’ve met see PCNs as vehicles for innovative, large-scale patient care approaches using ARRS roles.

However, I was surprised to learn how some forward-thinking practices with exceptional patient satisfaction felt disillusioned with their PCNs. Despite repeated efforts, they couldn’t gain support for broader PCN approaches that maximised ARRS benefits. As a result, they’ve refocused on their own practices.

These aren’t small practices – with 10,000-14,000 patients each. Yet, in PCNs of 70,000, their voices are easily lost due to voting structures.

This concerns me because Integrated Care Boards (ICBs) might not hear the full range of GP perspectives. The PCN model often leads to engagement with CDs, potentially creating the assumption they represent all member practices.

As we navigate general practice’s challenges, how can we ensure innovative, future-focused GPs who aren’t CDs have a voice and influence the future?