NAPC calls for a rethink of the draft DES service specifications based on learning from the primary care home model

NAPC calls for a rethink of the draft DES service specifications based on learning from the primary care home model

The National Association of Primary Care (NAPC) is today calling for NHS England and NHS Improvement to reconsider its process for primary care transformation, describing the draft service specifications as ‘too early and too detailed” following a survey of its members including primary care homes (PCHs).

It is highlighting learning from PCH sites where the approach to transformation was organic, locally-led and created a culture that empowered teams to innovate and design services based around their populations health needs.

NAPC are the architects of the primary care home (PCH) model – the original primary care network (PCN) which has informed national PCN policy.

Dr Nav Chana MBE, NAPC Joint Clinical Director, said: “We are urging NHS England and NHS Improvement not to stifle PCN innovation and not to over specify but give networks a chance to flourish locally.

“If PCNs follow the PCH approach and the learning of mature PCH sites, it is possible to get traction and achieve things, despite the current pressures that everyone is facing. This is transformation that is genuinely bottom up. It is about creating the right culture, the right environment which will lead to networks having more time and capacity to do structured medication reviews, for example”.

As NHS England and NHS Improvement’s consultation on the first five draft service specifications for primary care networks (PCNs) closes, NAPC is suggesting a rethink to its service specifications – highlighting its PCN model and six-step development cycle which can  support networks to achieve maturity in line with the NHS Long Term Plan.

The emphasis is on first building relationships and cross sector collaboration, developing priorities and services based on local needs.

In a survey of NAPC members including more than 240 primary care home sites, 84% of those who responded said there were factors that would prevent them achieving the service specifications.

Respondents felt the service specifications were too early in PCN development, relationships with community providers were not well enough established and to go ahead now would jeopardise the work they had achieved to date.

One respondent said: “I feel disappointed in these specifications. Personally, I feel that the work I have done in the past year to encourage colleagues, nurture new relationships and create plans has been in vain. I feel sorry for my younger GP colleagues – at least I am in the position that I can retire – and that may be sooner than I had originally planned.“

Other key themes related to a lack of resources – insufficient time, staff and money – at a time when primary care networks and general practice are ‘on their knees’ coping with demand, GP shortages and difficulty in recruiting to the additional roles.

Many felt the requirement for a clinical lead for each specification and requiring GPs to take on fortnightly nursing home reviews would impact on access for patients, reducing their surgery time.

Key learning from the PCH model was outlined in Insights from the spread of the primary care home model an independent report from The King’s Fund last year. It said that PCHs brought an enabling form of leadership – one that was organic, locally-led, practical, not top down that empowered colleagues and created a culture of compassion and valuing staff.

The success of the organic approach was highlighted by a PCH leader interviewed by The King’s Fund, who said: “… those that are doing really well haven’t got this formulaic synthesised approach. They’ve just done it naturally.

“They create empowered teams. It’s that simple: practical leadership that makes the difference between a successful primary care home and a maturing primary care home and those that don’t get off the ground”.

The full report including the seven factors that enabled the spread of the PCH model can be read here.

Further information on the primary care home model, the original primary care network can be found on the NAPC website.

Notes to editors

The National Association of Primary Care (NAPC) is a leading membership organisation representing the interests of primary care professionals including general practitioners, nurses, practice staff, pharmacists, opticians and dentists. It is at the centre of shaping the future of healthcare, spreading innovation, influencing policy, supporting and connecting professionals across primary care – enabling them to provide world-class sustainable patient-centred healthcare. For more information see

NAPC are the architects of the primary care home (PCH) model – the original primary care network (PCN) which has informed national PCN policy. There are now more than 240 PCH sites across England – with many leading the transformation of integrated primary care across England. The model brings together a range of health and care professionals to provide enhanced personalised and preventative care for their community. For more information see

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