Further to part one which sets out the key points regarding Network DES implementation, part two explores some of the potential network models available that can be tailored to meet different needs.
Options for collaboration
There is no one delivery model for a network that is the right fit for all, as we have seen to date from the move to at-scale working.
Model 1 – Unincorporated practice network (shared employment model)
Model 2 – Unincorporated lead practice network (hosted employment model)
Model 3 – Incorporated primary care network (non-contract-holding model)
Model 4 – Incorporated primary care network (contract-holding model)
Model 5 – Single provider network (generally in excess of 50,000 patients)
Model 6 – Non-GP employer host
Developing your network
Potential key issues to be considered:
- Host organisations: Does your federation hold a GMS/PMS/APMS contract? Is it willing to act as the host organisation for your network? Could your host also hold the employment contracts for additional staff? Will this affect eligibility for the NHS Pension?
- Employment: Will employment liabilities be subsumed by the host organisation or shared among network members? Who will be responsible for day-to-day management of the additional staff? Who will be responsible for the additional staff once funding ends?
- Network clinical director: Will the role be filled by appointment or election? Do you already have a suitable individual in place with capacity to take on the clinical director role? Do you have processes in place that you can replicate for the recruitment process?
- Governance: How will you make decisions as a network, e.g. on spend and service delivery? Do you already collaborate through a corporate model? Can its corporate governance be mirrored at network level or inform network governance? Can this be replicated for networks across your federation area? Do you operate under a MoU or alliance contract? Can its governance be mirrored at network level or inform network governance?
- Risk sharing: Do you need a risk/gain share mechanism in your Network Agreement? If so, will this be an even split or shared between practices based upon their list size? How will you share the risk of the employment?