Variability in size and characteristics of England’s Primary Care Networks: observational study

Background: General practices in England have been encouraged by national policy to work together at a larger scale by creating Primary Care Networks. Policy guidance recommended they should serve populations of 30,000-50,000 people to perform effectively.
Aim: To describe variation in the size and characteristics of Primary Care Networks and their populations.
Design and Setting: Cross-sectional analysis in England.
Method: Using published information from January 2020, we identified Networks that contained fewer than 30,000, between 30,000 and 50,000, and more than 50,000 people. We calculated percentiles to describe variation in size and population characteristics. We also examined Network composition within each commissioning region.
Results: 6,758 practices had formed 1,250 Networks. 726 (58%) Networks had the
recommended population of 30,000 to 50,000 people. 84 (7%) Networks contained fewer than 30,000 people. 440 (35%) Networks contained more than 50,000 people. 34 Networks comprised just one practice and 77 Networks contained more than 10 practices. Some Networks contained over double the proportions of older people and people with chronic conditions compared to others. More than half of the population were from very socioeconomically deprived areas in 172 (14%) Networks. All Networks were in the recommended population range in only 6 (4%) of the 135 commissioning regions. All practices had joined a single Network in 3 (2%) commissioning regions.
Conclusion: More than 40% of Primary Care Networks were not of recommended size and there was substantial variation in their composition and characteristics. This high variability between Networks is a risk to their future performance