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NHS sets out GP income protection and steps to limit non-essential work

By 07/01/2021No Comments

A letter  from NHS England officials including primary care medical director Dr Nikki Kanani sets out ‘further support we are taking to free up GPs, practice teams and PCNs to advance the vaccine rollout’.

Updated guidance from the BMA and RCGP is also expected later this week to help practices prioritise workload in the face of unprecedented pressure, amid a COVID-19 surge that has seen more than 400,000 new cases confirmed in England in the past week alone.

The letter confirms that CCGs have been told to ‘minimise local contract enforcement across routine care’ and to suspend all locally-commissioned services apart from those that support COVID-19 vaccination or other elements of the local pandemic effort.

GP income protection

Funding for any locally-commissioned services halted should be ‘protected to allow capacity to be redeployed’, the letter says.

Funding for PCN clinical directors from January to March will be quadrupled from 0.25 whole-time equivalent (WTE) to 1 WTE, the guidance says. This will apply in areas where ‘at least one practice is participating in the COVID-19 vaccination enhanced service’ and can be ‘flexibly deployed’ to support local sites managing the COVID-19 vaccination response.

Minor surgery DES income – along with ‘additional service income related to minor surgery within the global sum – will be protected until March 2021.

Income protection for QOF points will see the quality improvement domain ‘protected in full at 74 points per practice until March 2021’, while the eight prescribing indicators within QOF will be ‘income protected on the same basis as the existing 310 points which have been income protected’.

GP appraisal

The letter confirms that appraisals ‘can be declined during this period’ – and that where GPs choose to go ahead the revised 2020 model must be used.

The letter highlights areas that ‘represent the biggest priorities for general practice over the coming quarter’ beyond the COVID-19 vaccination campaign.

A list of key points set out in the letter says:

  • Ensure general practice remains fully and safely open for patients, including maintenance of appointments.
  • Supporting establishment of the simple COVID [email protected] patient self monitoring model and identifying and supporting patients with Long COVID.
  • Continuing to support clinically extremely vulnerable patients and maintain the shielding list.
  • Continuing to make inroads into the backlog of appointments including for chronic disease management and routine vaccinations and immunisations. Note that any prioritised chronic condition management reviews may be carried out remotely where clinically appropriate.
  • On inequalities, making significant progress on learning disability health checks and ethnicity recording.

Plans to incorporate extended access requirements into the PCN DES have also been delayed under an agreement with the BMA, the letter confirms – and the move is now unlikely to happen before April 2022.

Extended access

The letter says: ‘Given the uncertainty around the timing of the COVID vaccination programme, we have agreed with the British Medical Association’s General Practitioners Committee (England) that we will delay the planned introduction of the new standardised specification for extended access as part of the Network Contract DES – and the associated national arrangements for the transfer of CCG extended access funding.

‘We do not anticipate that the national introduction of the new enhanced access service or the associated transfer of funding will take place before April 2022. The extended hours access requirements in the existing Network Contract DES will remain as they are for the same period.

‘In instances where the capacity is not required for vaccine delivery, it should be used for local priorities. This includes access to urgent and pre-booked appointments over the coming winter months. CCGs must now make arrangements for the CCG-commissioned extended access services to continue until April 2022. Where these services are already commissioned from PCNs, we would expect these arrangements to continue.’

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