Once a remainer, always a remainer

As ever, I’ve been very busy. I’ve managed to squeeze in a couple of conferences, a job interview, and a netball tournament (daughter, not me) and most notably for this audience our PCN away afternoon.

This is an annual affair where we gather all the ARRS staff and wider team to catch up on changes and see how we might be able to cross-pollinate and share learning. This is followed by board meeting where we set strategy for the new year and review our services.

The away day always has a theme - this year it was lifestyle medicine. We went to a local hotel and stayed 'on message' eating plant-based kofte, which had mixed reviews, and were only permitted one small cake each.

We pay for it out of our PCN budget and I like a bit of merch, so this year it was a water bottle. We have had stress balls and lanyards in the past - I'm improving in this area one year I created 50 folders - all of which spelt one of the practice names wrong and so I had to pay my 11 year old to Tippex out the extra letter. Anyway I digress...

It’s always an interesting afternoon when all the ARRS staff get together and reflect on what we have, and imagine how we’d like to move forward.

With the future in mind, I decided we needed a vision for our organisation. I do love a good vision: read by nobody, lurking on PowerPoint slides until the CQC shows up — and then suddenly, it becomes the mantra to which we all solemnly abide.

So here it is —

With one third of GPs surveyed saying they believe PCNs should be abolished, I can’t help but wonder whether they ever really bought into a vision — or if they ever will. For someone like me, who ardently believes in PCNs (as I did in Europe), I can feel my heart breaking all over again.

Primary care at scale has never been more important than it is now. Most individual practices are simply not big enough to survive — let alone thrive — in the neighbourhood landscape that’s coming.

I hope that framing the PCN in this context might help the 'leavers' understand that this isn’t something to be taken lightly. We have a real opportunity to Make Primary Care Great Again - forgive the reference.

While discovering the health benefits of lifestyle medicine, I looked around the room and thought: 'this is it'. This is the prevention agenda the higher powers keep talking about. The dietitian, the mental and physical health coaches, the mental health worker, etc. Their value isn’t in financial terms, they don't generate income — but the good they do in the preventative space is enormous.

The old argument that we’re just propping up other parts of the system still has merit. But when I really think about the potential of our PCN, I know we’re ready for the left shift. We’re ready to provide seamless, preventative care.

I remain, a remainer, firm in my belief that a union of practices working together in a PCN will make primary care, and ultimately all who work in it, stronger.

Dr Sian Stanley is clinical director of Stort Valley and Villages PCN, East of England CD Representative, NHS Confederation and a GP partner in Bishops Stortford, Hertfordshire. Read more of her articles here