There's no published matrix for how integrated care boards (ICBs) will assess PCN performance. But that doesn't mean the picture isn't forming.
The strategic commissioning framework and medium term planning framework both signal a shift towards more active primary care oversight. ICBs are being told to undertake risk-based assessment, apply contractual levers, and intervene where necessary. And while regional teams take over provider trust performance from April 2026, ICBs retain accountability for primary care.
None of what follows is new. But depending on how engaged you are with the primary care network agenda, it may be useful to see it pulled together in one place.
If you're part of your PCN's leadership or management team, you'll likely recognise everything here. But for those closer to day-to-day practice focused on patients, rotas, and the immediate demands of general practice – this may provide useful context.
When your PCN management team asks for data, or raises questions about access or workforce, this is the backdrop. Contract management of primary care networks is increasing, and the information your leadership team is collating is part of how your PCN demonstrates what it's delivering.
So here's what we know PCNs need to be across.
1. Core contract delivery
The foundation – access, same-day response, continuity, capacity, digital adoption. ICBs are explicitly told to identify practices struggling to deliver and to plan support or intervention accordingly.
The national targets:
- 90% same day appointments for all clinically urgent patients
- Year-on-year improvement in patient experience of access (ONS Health Insights Survey)
2. ARRS and workforce
Your additional roles reimbursement scheme spend is visible to your ICB. Expect them to consider:
- Allocation and utilisation
- Role mix and alignment with local priorities
- Impact on access, capacity, and outcomes
- Retention
3. Neighbourhood health contribution
The immediate priority cohorts are:
- People with moderate to severe frailty
- People living in care homes
- People who are housebound
- People at the end of life
From April 2026, ICBs must understand service utilisation and costs for these groups, create plans to reduce avoidable admissions, and take remedial action if non-elective demand continues to rise.
Collaboration maturity matters too. ICBs will assess the degree of service integration – how you're working with neighbouring PCNs, community services, mental health, social care, local government, and the VCSE sector.
4. The qualitative picture
ICBs won't rely on numbers alone. The frameworks require triangulation with:
- Complaints data
- 'You and Your General Practice' intelligence
- Freedom to Speak Up reports
- Patient Safety Incident Response Framework data
- Feedback from patients and staff
Putting it together
| Area | What they'll look at |
| Access | Same-day urgent, mode of contact, continuity |
| ARRS | Spend, role mix, utilisation, impact |
| Priority cohorts | Utilisation, admissions, costs for frail/housebound/care home/end of life |
| Collaboration | Partnership maturity, integration, place-based contribution |
| Quality signals | Complaints, incidents, feedback trends |
| Contract delivery | Enhanced access, DES requirements, digital adoption |
For individual practices, your contribution to the network isn't separate from this picture – it's part of it. PCN performance is collective. If one practice is ‘underperforming’, it affects the whole network, financially and strategically. Your performance shapes how the entire network is understood.
Beyond the tick boxes
This may feel like a tick-box exercise. But these are contractual requirements that PCNs have signed up to deliver, funded by public money. The boxes exist for a reason.
That said, data alone never tells the whole story. PCN leaders need to be able to fill in the boxes and pick up the phone. The relationship with your ICB matters – not to spin a narrative, but to provide context, explain the challenges behind the numbers, and ensure they have a complete picture of your network.
If your ICB only knows you through your data submissions, they'll draw their own conclusions. If they know you through conversation too, you have a chance to shape the understanding.
Both matter. Evidence your performance and build the relationship.
Tara Humphrey is CEO of THC Primary Care, which provides interim management training to PCN leaders and has supported more than 300 PCNs.