The updated January 2023 Primary Care Network DES and a dashboard to measure your progress

Who and what is this blog for?

As always, we write our blogs for those new to PCN Management, and the purpose of this blog is to summarise the latest PCN guidance published on 31st January 2023.

A key part of the PCN Management role is to stay on top of guidance and quickly distil what warrants your attention and what can be skimmed over.

A huge advantage is that the PCN community loves to share, so guidance should be hard to miss if you are subscribed to the right platforms.

To help with this, please check out the blog titled 7 platforms every Primary Care Network Manager should be subscribed to.

Information in this blog will be repeated in other areas of the THC blog, but learning through repetition is hugely valuable in this role, so if you see something that reinforces what you already know, then this is good news and should help build your confidence.

You'd also be surprised about the number of new people who visit our blogs each week, so within each blog, we try our best to signpost you to other resources (as we have published over 200 blogs).

What is the DES?

The Network Contract Directed Enhanced Service (DES) was introduced during 2019 and will remain in place until at least 31 March 2024. This specification largely directs the PCN, providing guidance and parameters to govern the use of NHS monies and activities.

You don't need to memorise it, but it needs to be close to hand as many answers can be found in the DES.

The latest DES can be found here, but you may need to refer to other documents which we have compiled for you here: The latest Primary Care Network Guidance Documents updated in January 2023.

What's new in the PCN DES?

The good news is hardly anything!

In this document, on page 1, it clearly states what changes have been made using a colour-coded system which is really helpful.

This colour-coded system will enable you to see the only change since December, which is on page 42. It relates to the national subjective and finance system codes for Network Contract DES payments, which now include the code for the PCN support payment.

PCN Roles and Terms and Conditions

A significant amount of activity in your PCN is likely to centre around your PCN Team, predominately funded by the Additional Role Reimbursement Scheme (the ARRS workforce).

If you are looking for role descriptions and terms and conditions, here's the very latest from the most recently published version of the DES;

1. 8.2.1. Employers of staff recruited under the Additional Roles Reimbursement Scheme will determine what terms and conditions, including salary, they offer new staff and may consider using Agenda for Change bands as a guideline. In doing so, they should take a fair approach with regard to remuneration relative to other staff already working within and across the PCN GP member practices.

2. 8.2.2. Employers will decide the job descriptions of their own staff, ensuring they incorporate the minimum role requirements outlined Annex B of the Network Contract DES Specification and bearing in mind the abilities of the roles to support the delivery of network services.

If you want to learn more about the ARRS roles, check out A Comprehensive Guide to the Primary Care Network Additional Role Reimbursement Scheme 2022/23.

We are well aware of the demand for sample job descriptions, and outside of our own THC guidance, my first port of call for these would always be NHS jobs for ideas.

Subcontracted Roles

On page 27, an update which dates back to October 2022 highlights the requirements for subcontracted, remote clinical pharmacy services under the ARRS, (common sense would apply this to all roles), which are;

The commissioner and PCN must be assured that all requirements of the Network Contract DES are being met in full for a remote service arrangement to be eligible for reimbursement.

Commissioners should make an assessment on an individual basis as to whether the service is delivering the full Network Contract DES requirements, rather than the employment model. Where the requirements of the Network Contract DES are not met, commissioners can withhold the ARRS payments for the relevant role.

If you have a provider delivering services for you, and you would like to clarify the expectations (and understand the progress delivered to date), please check out our blog, How To Manage Your Additional Role Reimbursement Scheme (ARRS) Provider.

PCN Finance Codes

If you missed the updates which came in November, and you have recently taken on responsibility for finances, please familiarise yourself with page 42 onwards and the National subjective and finance system codes for Network Contract DES payments to make it easier to decipher what each payment is for.

Create your plan

If you feel you have a good grasp on network requirements, the next phase is to create a plan. Please check out our guide, What to focus on in Q4 - A Guide for Primary Care Network Leaders.

As we approach the end of the year, don’t worry if there is a sense of urgency in your network because you are not on track to hit your targets. Keep a cool head and;

1. Work out where you are using a tool like Ardens Manager, or ask your practices to run their searches

2. Identify low-hanging indicators and wins

3. Speak to your clinical leads and PMs and work out your plan of action.

4. Communicate, communicate and communicate your plan. Using a simple visual dashboard like the one below may be helpful. You will of course need to add some narrative to this to communicate what you plan to do.

If you feel overwhelmed, click on the image below, which walks you through some key questions to help promote clarity.

We hope this helps!

About the Author

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have published over 200 episodes.

I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 PCNs by providing interim management, training and consultancy.

I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.

I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.