Context:
As the NHS continues to decentralise and shift care closer to home, Primary Care Networks (PCNs) are becoming an increasingly critical — and often overlooked — stakeholder in medicines access and implementation. At the NeoNavitas Sub-National Access Conference, Vishal, a Clinical Lead for Medicines Optimisation and practising primary care clinician, provided a candid, grounded perspective on how PCNs operate, how decisions are made, and how pharma can engage meaningfully.

1. The Decision-Making Reality of PCNs

Officially, PCNs are not statutory decision-making bodies. But in practice, they often act as such. Whether it’s adopting new pathways, launching locally commissioned services, or choosing which therapies to prioritise, Vishal made it clear: “If we want to do something, we will.”

This agility means PCNs can implement projects rapidly — with minimal bureaucracy. But it also means engagement must be local, relationship-based, and built on trust.

2. Engagement is Easier Than You Think — and Harder Than It Looks

The governance burden in primary care is low compared to ICBs — there are no lengthy forms, no national gatekeepers. “We can often make a decision over WhatsApp,” Vishal explained. But that doesn’t mean access is easy.

Legacy mistrust, past experiences of abrupt project withdrawals, and misconceptions about pharma’s motivations have left some PCNs hesitant to engage. A strong starting point, said Vishal, is to “start small, deliver well, and build from there.”

3. It’s Not Just About GPs Anymore

The traditional GP-dominated model is giving way to a multi-disciplinary approach. PCNs are increasingly staffed by pharmacists, nurses, physios, and other ARRS-funded roles — each a potential partner in service delivery and medicines optimisation.

Knowing who to speak to within a PCN — and understanding how that varies from place to place — is critical. In some cases, clinical directors are hands-on. In others, they delegate fully to senior pharmacists or network managers.

4. Pharma’s Role in Supporting Pathway Redesign

Vishal highlighted examples of successful industry partnerships that had improved patient outcomes, enhanced clinical workflows, and enabled innovative service models. But he also shared cautionary tales — of companies disappearing mid-project, or pulling funding unexpectedly.

“Don’t overpromise. Be consistent. Understand our pressures,” was the message. Projects that support system-wide goals — like clearing backlogs, reducing variation, or improving medication safety — are far more likely to succeed.

5. Practical Priorities and Pressure Points

PCNs are under significant operational pressure. Key challenges include:

• High demand and workforce strain

• Frustration with over-reporting and misaligned ICB/NHSE priorities

• Unmet patient needs due to delayed specialist care and limited access to new therapies

• A lack of clarity around implementation support following NICE TAs

Pharma can support by helping translate guidelines into practice, offering education, or co-developing patient-centred solutions that reduce the load on overburdened services.

Conclusion: Opportunities at the NHS Frontline

PCNs are no longer “nice to have” in your engagement plan — they are essential. They’re nimble, diverse, and increasingly influential in shaping what gets prescribed, how care is delivered, and where innovation happens.

But they’re also under pressure and resource-constrained. Success with PCNs depends not on the scale of your investment, but on the relevance of your offer, the consistency of your support, and your ability to speak their language.

At NeoNavitas, we help pharma teams understand how PCNs work, who to engage, and how to develop partnerships that work in the real world of primary care.

To explore how we can help you make an impact at the frontline of the NHS, get in touch with our team.