PCN opt-in/out anonymised example

This example should be read in conjunction with our main advice on factors to consider when deciding on continued participation in the PCN DES.

For a 50,000 patient PCN the income will be £373,000.00 per annum.

The centre will need to be opened 15.5 hours per week and offer 50 hours of consulting per week.

Allowing 20% for non-staff costs (building, insurance, office/medical disposables etc) and 10% to manage the service this leaves a budget of £261,100 to fund the staffing and management of the service.

A GP will not need to be on site but will need to be available, assuming that this GP will need to be paid at a normal rate, the most cost-effective model would be to have one GP, one practice nurse and one healthcare assistant (1.5 on a Saturday) this would give 50.5 hours per week so would cover the minimum requirement.  In addition, two receptionists would be required throughout these hours.  This model would cost around £139,500 per annum to deliver.

The most expensive model would be having GPs throughout the 50 hours per week.  This model would cost £260,715 per annum to deliver, which would just be in budget.  This may sound deliverable, but there are several significant/problematic assumptions in this modelling:

  • being able to get a GP to work extended hours for the equivalent rate of £100 per hour,
  • paying a Band 7 PN at an hourly rate of £20 per hour, and
  • paying HCAs/receptionists at the London Living Wage of £11.05 per hour,

These are unsociable hours, and the rates may be considerably more.

It assumes that a member practices of a PCN will be able to staff the hours, but if they cannot do this, it is unclear who is responsible.

There is no allowance to cover annual, study and sickness leave or for recruiting, training and supervising new staff.

If all these people are salaried then the cost potentially increases by 2/13th to allow for leave which would increase the staff costs to £161,000-£300,825 depending on the skill mix.