How Primary Care Networks and practices can work together effectively

Primary Care Networks (PCNs) were introduced to support collaboration between GP practices and strengthen services across local communities. By working together, practices can share resources, coordinate services, and expand multidisciplinary teams.

However, while the concept of collaboration is straightforward, governance arrangements between PCNs and individual practices can sometimes become unclear.

Understanding how responsibilities are shared — and where accountability sits — is essential for maintaining effective and well-organised networks.

Understanding the Structure of a PCN

A Primary Care Network typically brings together several neighbouring practices that collectively serve a defined patient population.

Each PCN is led by a Clinical Director, supported by practice leaders and network staff.

The PCN operates alongside individual practices rather than replacing them. Each practice retains responsibility for its own services, contracts, and governance obligations, while the network provides additional coordination and shared initiatives.

This dual structure means that clear governance arrangements are essential.

Defining Responsibilities Clearly

One of the most important aspects of PCN governance is understanding which responsibilities sit with the network and which remain with individual practices.

For example:

PCN responsibilities may include

  • coordination of ARRS roles

  • delivery of enhanced services

  • shared projects or initiatives

  • network-level workforce planning

Practice responsibilities typically include

  • core GP contract delivery

  • patient care within the practice

  • internal workforce management

  • premises and operational governance

While collaboration is encouraged, maintaining clarity around accountability helps prevent confusion.

Supporting Collaboration Between Practices

PCNs often enable practices to share knowledge, resources, and expertise.

Examples of collaboration may include:

  • shared pharmacists or pharmacy technicians

  • joint quality improvement projects

  • coordinated safety alert processes

  • shared learning from incidents or audits

When collaboration is structured well, it allows practices to benefit from collective expertise while maintaining their own operational independence.

Maintaining Transparency and Communication

Effective PCN governance relies heavily on communication.

Regular meetings between practice managers, clinical directors, and PCN staff help ensure that everyone understands current priorities and responsibilities.

Common governance structures may include:

  • PCN board meetings

  • operational planning meetings

  • workforce planning discussions

  • quality improvement reviews

Clear meeting structures help networks maintain transparency and shared understanding.

Managing Shared Workforce Roles

One of the most visible aspects of PCNs is the introduction of multidisciplinary roles through the Additional Roles Reimbursement Scheme (ARRS).

These roles may include:

  • clinical pharmacists

  • pharmacy technicians

  • care coordinators

  • social prescribing link workers

  • physiotherapists

Managing shared staff across multiple practices requires clear agreements around supervision, workload, and reporting structures.

Without clear arrangements, confusion can arise around who is responsible for day-to-day oversight.

Documenting Governance Arrangements

Many networks benefit from documenting their governance arrangements clearly.

This may include:

  • role descriptions

  • reporting structures

  • decision-making processes

  • financial oversight arrangements

Documented governance helps ensure that both PCN leaders and individual practices understand how the network operates.

It also provides useful reference points when staff roles change or new initiatives are introduced.

Supporting Practices Rather Than Adding Complexity

When PCNs function well, they provide additional support and capacity for practices.

They can enable practices to deliver services that would be difficult to provide individually, while also encouraging shared learning across organisations.

However, strong governance is essential to ensure that collaboration remains constructive rather than creating additional complexity.

Clear responsibilities, open communication, and structured oversight allow PCNs and practices to work together effectively for the benefit of both staff and patients.