The primary care network juggernaut shows no sign of stopping, says our GP blogger Dr Livingstone

The cut-off date for GPs agreeing on their primary care networks (PCNs) – the big new idea of the big new GP contract – is frighteningly tight, with sign-up required by 15 May. Yes, this year.

So, given this time-warping deadline, it should come as no surprise that a lot can happen on Planet PCN in six days. Specifically, a vague hope can morph into a concrete mandate.

First, out of a clear blue 1 April sky, we had The Pharmacist reporting that NHS England had decreed PCNs ‘will be expected to have a wide ranging membership...this should include providers from the local system such as community pharmacy, optometrists, dental providers, social care providers, voluntary sector organisations, community service providers or local government.’

This represented the first mention of any form of extended PCN membership and would clearly require a room the size of Wembley Stadium, so some were tempted to dismiss the story based on its date.

But this was no joke. Six days later, The Pharmacist reported that the just-released service specification stated, ‘PCNs will increasingly need to work with other non-GP support this, the Network Contract DES will be amended for 2020/21 to include collaboration with non-GP providers as a requirement.’

Wow. That’s ‘should’ to ‘will’ and ‘expectation’ to ‘requirement’ in less than a week, with the promise of a re-write of the DES before the ink on the original is dry. At this rate, by the time this blog is finished, pharmacists, optometrists and dentists may have sorted out Brexit.

Clearly, involvement and integration do make sense. What’s unnerving is the drip-drip of information and the sense that the master plan is evolving depending on how many back-of-the-envelopes happen to be available.

The more we hear, the less we understand. What does ‘membership’ of the PCN mean, exactly? Will it involve a commitment in time, money or both? How can collaboration be mandated and monitored? Will those non-GP providers have input into PCN meetings? Will they have votes? Will they share liabilities? And who has time for all of this?

Nobody knows. Though doubtless in another six days, all will be clear.