Legal support for primary care networks

The Confederation has commissioned a package of legal support for primary care networks from our legal advisors, Hill Dickinson. The support includes legal formation, governance and decision making, principle setting and dispute resolution, admission and exit processes, data and information sharing agreements and processes, and the appointment and employment support of clinical directors.

This has been arranged in response to request for support from our members and will be available to every PCN in the city.

There is no cost to PCNs as the costs are being met by the Confederation budget for primary care development.

Each practice will be provided with a dedicated legal contact, who will coordinate support across the various legal teams: commercial/contract, employment, pensions, governance and tax.

In addition, the dedicated legal contact will attend networks meetings to present and facilitate discussion on the options and collate a detailed response/first approach from networks and produce an accurate first draft network agreement. The outcome of the support will be a complete network agreement to meet for the 30 June deadline.

The support package includes the following elements:

 

Legal forms of a primary care network

  •   Personal attendance at network meeting to run through legal and contracting forms of primary care networks. Assessing advantages and disadvantages of each and associated key considerations including risk/gain share, contracting, workforce models, pensions, VAT and governance.
  •  Development of a network agreement to serve as an agenda for the session, pulling together the information required to develop the schedules and associated documents.
  •  Networks will not be left to navigate this document; it will be populated in conjunction with a Hill Dickinson representative at the network meeting to help maximise the time we have but also provide and options when developing the prepared approach for the network.
Governance and decision making

  •  Support the development of the detailed network governance model. Advising and resolving provisions such as voting, reserved matters, establishment of an executive if applicable), managing conflicts, selection and development of service models per specification release. Appointment process of clinical director and rotation of post. Identify link into Confederation
  •  Development of draft schedule 1 for review and comment.
  •  Allow for two further iterations to schedule to allow for agreement and completion.
Principles    

  •  Development of the network principles/ways of working. Consider and discuss development in line with local strategies but ultimately seek to develop and agree a bespoke set out principles and ways of working between practices within the network.
  • Using our experience of working with other public and private sector organisations in the establishment of joint ventures.
  • This will form part of the network questionnaire discussed and completed with Hill Dickinson attendance at a meeting of the network
Clinical director (appointment mechanism)

  • Developing mechanism for the recruitment/retirement of the clinical director position in an open and transparent manner aligned to DES guidance.
  • Develop a suite of documents for the future recruitment of the clinical director including outline job specification, expression of interest form. See below for development of clinical director contract and options for recruitment model.
Information sharing

  • Develop information sharing models between network members. See data sharing element below for further detail. This will form part of schedule 2 but also form part of a stand-alone suite of data sharing documents as detailed below.
Intellectual property

·         Options appraisal of shared intellectual property rights and shared exploitation.

·         Development of provisions on the sharing of IP.

Admission and exit

·         Developing provisions/mechanism for the admission and exit of practice and non-core practice members into the network. Link to DES specification and the penalties/implication on exit and ongoing service delivery for applicable practice patients.

Dispute resolution

  • Developing a dispute resolution procedure. Consider links to Confederation to offer impartial support before moving to costly mediation.
Data sharing agreement

  • Networks are required to enter into a data sharing agreement to govern the sharing of patient data between network members.
  •  template agreement is anticipated from NHSE. The form is not mandatory and given the fast approaching timescales we will produce a data sharing agreement (aligned with the NHSE template if available).
  • Our detailed questionnaire referenced above will include questions and key considerations for networks which will enable us to produce a detailed first draft agreement for your consideration.
  • We will attend in person to work through the questionnaire with you explaining the key considerations and exploring the data flows which will impact upon the drafting and also identify the need for additional bespoke elements below.
  • At the infancy of the network it may be that the data flows (linked to the contracting models) are yet to be determined and we can talk through with you the triggers to watch out for as the Network developments that will mean further provisions are required to maintain compliance.
Nominated payee agreement/mandate

  • Development of nominated payee agreement – documenting the basis on which the payee holds funds on trust for the network. This arrangement may be between a practice as payee or the Confederation as payee.
  • Document will consider powers/freedoms to administer the funds and settle creditors. In will consider agreed spend/budgets and also the link to the governance and level of approval required for agreed spending limits.
  • Detail the risk being assumed by the nominated payee and agree appropriate indemnities linked to extent of responsibility i.e. banking role only or duty to verify funds.
  • Advice of accounting and tax considerations of the nominated payee options.
Core documentation

  • Development of core workforce agreement based on preferred model, e.g. shared or hosted employment.
Pensions

  • Ad hoc pensions advice as required linked to the chosen workforce model.

Locality managers will coordinate the rollout of the legal support package within PCNs and will shortly contact lead managers to begin this process.