Robert McCartney, an associate at Hemsons, is back again, as they explore his recent work on PCNs and integrated neighbourhood teams. Robert shares his insights into the complexities of creating legal constructs for these collaborations, emphasising the importance of contractual agreements with community services and third parties like pharmacies and charities.  Ben & Robert also touch on the broader landscape of how PCNs are evolving and the impact this has on healthcare delivery and collaboration. In this episode, they focus on the recent updates to the premises cost directions, which govern funding and access to funds for GP premises. These changes include the potential for 100% improvement grants and funding for land purchases, offering some relief to practices facing financial pressures due to increased demand and the influx of PCN staff. They look at the implications of these updates, such as the expanded ability for commissioners to use a broader range of valuers, the impact on VAT negotiations, and practical steps practices should take to navigate these new directions effectively. Introduction (00:09)  Finding ways of developing new services together (00:37) Contractual agreement.. (01:11) The premises cost directions (01:48)  Why now? (02:53) What are the main changes in the new updates? (03:53) Carrying out necessary extensions.. (05:53)  What’s the catch? (06:48) 18 year commitment (08:06)  Last man standing (09:14) But the money isn’t there.. (09:46) How to get better access to the funds.. (11:25) Other changes.. (12:06)  Further guidance.. (13:17) Freedom for practices.. (13:54) PCNs.. (15:27) VAT implications.. (16:19)  Next steps.. (17:18) Is this positive? (18:29) Getting in touch.. (19:37) Contact Robert via email here.  For all enquiries about the Ockham podcast, please contact Ben Gowland here.