Primary care network
Primary care networks were introduced into the National Health Service in England as part of the NHS Long Term Plan, published in January 2019. The 2019 General Practitioner contract gave the opportunity for GP practices to join networks, each with between 30,000 and 50,000 patients. The stated aim is to create fully integrated community-based health services which will be an important component of integrated care systems. By June 2019 1,259 primary care networks had been established across England, with an average population covered of about 42,000 patients, and including all but about 55 practices. About 25  had decided not to participate. Networks will be required to deliver seven national service specifications. Structured medication reviews, enhanced health in care homes, anticipatory care (with community services), personalised care and supporting early cancer diagnosis were to start by April 2020. Cardiovascular disease case-finding and locally agreed action to tackle inequalities are to start in 2021. This model was pioneered by the vanguard projects established under 2014's Five Year Forward View. The networks will hold local contracts for enhanced services. They will have 'expanded neighbourhood teams', which the plan envisages 'will comprise a range of staff such as  GPs, pharmacists, district nurses, community geriatricians, dementia workers and allied health professionals such as physiotherapists and podiatrists/chiropodists, joined by social care and the voluntary sector'. Evidence of the effectiveness of this approach is rather limited, according to a 2019 review in the "Health Policy" journal. Modality Partnership and Our Health Partnership, two of the biggest GP super-partnerships, proposed in 2019 to lead networks across the country, which may include practices not in their organisations. Staffing. Funding will be provided for the employment of clinical pharmacists and social prescribing link workers in 2019/20, and subsequently for physiotherapists, physician associates  and paramedics. Each network was given £37,810 to fund a clinical pharmacist post for 2019/2020, to cover 70% of the costs, with the network expected to cover the rest. The intention is that each network will have five clinical pharmacists by 2024 – about one per practice – providing altogether an additional 7,500 pharmacists. In November 2019 NHS England announced a change in financial rules which will permit networks to meet management costs of the charities and other organisations which supply social prescriber link workers.