Earlier this week, NHS England announced various changes to the 2023/24 GP contract. We have briefly summarised six of the key areas of change.

New access requirements

• Patients will be offered an assessment of need or signposted to an appropriate service upon making initial contact with the practice. Therefore patients will no longer be asked to contact the practice at a later date/time. 
• Patients will have online access to their prospective medical records for new health information by 31 October 2023.

Cloud based telephony

• From the end of 2025, and subject to termination of current telephony contracts, practices will be required to procure their telephony solutions from the recommended suppliers provided by the Better Purchase Framework.

GP retention scheme

• NHS England will permanently remove the four session cap within the GP retention scheme and sessions worked above the cap will be funded by the employing practice.

Additional Roles Reimbursement Scheme (ARRS)

• The cap on Advanced Practitioners will increase from two to three where the Primary Care Network’s (PCN) list size totals 99,999 or fewer and from three to six where the PCN’s list size number 100,000 or over.
• PCNs will be reimbursed for the time that First Contact Practitioners spend out of practice training to become Advanced Practitioners.
• Advanced Clinical Practitioner Nurses and apprentice Physician Associates will be added to the roles eligible for reimbursement.
• All recruitment caps on Mental Health Practitioners will be removed.

PCN service specifications

• No additional requirements will be added to PCN service specifications in 23/24.

Changes to Impact and Investment Fund (IIF)

• The number of indicators in the IIF will be reduced to five. These indicators will concentrate support on flu vaccinations, learning disability health checks, early cancer diagnosis and two-week access indicator. The value of these indicators will be £59 million. 
  
  The remainder of the IIF will be worth £246 million and will focus on improving patient experience of contacting their practice and being assessed and/or seen within the appropriate timeframe.
• 70% of the total funding (£172.2 million) will be provided to PCNs as a monthly payment during 2023/24 via the Capacity and Assess Support Payment.
  
  The remaining 30% (£73.8 million) will be awarded at the end of March 2024 subject to the PCNs demonstrating to the Integrated Care Board (ICB) that there has been improvement in patient access (assessed against an access and improvement plan agreed with ICBs in Q1 23/24). The ICB will carry out an assessment to form its decision.
  

Changes to the Quality and Outcomes Framework (QOF) QI modules

• Once the 2022/23 outturn is finalised, funding (of £97 million) will be paid to practices. Payment will based on 2022/23 performance.
• The number of indicators in QOF will reduce from 74 to 55.
• Two new cholesterol indicators and as well as an overarching mental health indicator will be added to QOF.
• This year’s QOF QI modules will focus on (1) workforce wellbeing and (2) optimising demand and capacity in general practice.

Immunisations and vaccinations

• The vaccination and immunisations repayment mechanisms will be removed. This will result in the removal of the payment clawback for practice performance below 80% coverage across routine childhood programmes.
• The lower thresholds of the childhood vaccination and immunisation indicators within QOF will be reduced to 89% (VI007 86% (VI002) and 81% (VI003) and the upper thresholds will increase to 96%.
• The GP contract will be also updated to reflect the introduction of a new Personalised Care Adjustment which will enable the vaccination of patients who have registered too late.

How Capsticks can help

Our primary care team advise primary care providers on a range of commercial and contractual arrangements as well as employment and engagement of ARRS roles within PCNs, including PCN incorporation and documenting arrangements between GP Federations and PCNs. This includes advising on structural options and network models, drafting a tailored and bespoke Network Agreement schedules for each PCN and advising on workforce, employment and HR. 

If you would like any further information please contact Mark Jarvis in our primary care team.

You can otherwise look out for our next insight on the revised Network Contract DES specification which NHS England will be publishing later this month.