![]() If the four practices work together on a project where there is individual accountability for each practice, like a delivery against a key Investment and impact fund indicator: this is more difficult than the previous step because the practices have to work out how accountability and support will work across the practices, such as what happens if one practice is not able to fulfil its delivery requirements.If the four practices work together on a shared project that creates additionality for the practices, such as a first contact physiotherapy service: the practices find a way of working together so that they can agree on the location and operation of the new service, how it is organised, how they can use it, and how they can benefit from it. ![]() If the four practices share a resource, such as a pharmacist: they work on this until they can do it in a way that means all four practices feel they are benefitting from the shared resource, no practice is feeling hard done by, and the pharmacist is happy.Some examples of what these progressions could be – with the assumption that were are discussing a PCN of four practices – include: The group of practices in the new PCN need to learn how to work together by using a series of progressions, taking steps of increasing difficulty and complexity, so that they can learn ways of working together that will enable them to do more and more together. This idea of progressions applies equally to PCNs and joint working between practices if a group of practices starts off by trying to run a shared urgent care service across core hours without ever having worked together before, it will most likely run into serious problems very quickly and the project will have to be shelved. Instead, you have to work through the progressions so that you learn how the shot feels, what adjustments you have to make, and then make them habits that you can rely on in a match situation. However, if you start off by watching Roger Federer’s backhand – and then immediately try and hit it like Federer at full speed in a match situation – you will inevitably fail, and revert to your old backhand. You will continue to progress until, ultimately, you can hit your new and improved backhand on a regular basis. ![]() You start with something relatively simple and then, when you can do that task consistently, you move onto something slightly more difficult, and focus on that until you can do that well.įor example, first, you hit a ball that is dropped next to you, then one that is fed to you from a coach’s basket, then one that is hit in a friendly, collaborative rally, and so on. This involves breaking down a complex task into a series of easier steps, working up to the final result. One of the key principles in tennis when learning something new is the idea of ‘progressions’. When I’m not working with general practice I spend much of my time playing tennis. This episode was presented by GPonline editor Emma Bower and produced by Czarina Deen.Ben Gowland, director of Ockham Healthcare, and a former NHS CCG chief executive, believes that primary care networks need to start small in order to progress to successĬREDIT: This is an edited version of an article that originally appeared on Ockham Healthcare We also talk about what integrated care systems and the Fuller report could mean for PCNs and why it's important for general practices to work together to have the biggest possible influence in their local area. Emma speaks to Ben Gowland, director and founder of think tank and consultancy Ockham Healthcare and host of the General Practice Podcast.īen does a lot of work with primary care networks (PCNs) across England and in this conversation we look at what the future holds for PCNs as we enter the final year of the five-year GP contract that led to their introduction in 2019.īen explains why he thinks it's so important that practices engage with their PCN and the opportunities he believes PCNs provides practices.
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