In December, NHS England (NHSE) wrote to practices, setting out temporary measures to primary care contracts to support contractors with capacity while dealing with the Omicron variant and delivering the vaccination programme.

We have summarised the key temporary variations below as well as the changes to the 2021/22 Network Contract Directed Enhanced Services (DES).

Quality and Outcomes Framework (QOF)

• Contractors should focus on the four vaccination and immunisation indicators, the two cervical screening indicators, the register indicators and the eight prescribing indicators. Payment to be based on practice performance.
• 46 QOF points for new indicators will be reallocated due to a lack of historic performance to base income protection. 
• The remaining indicators will have income protection based on a methodology similar to that applied in 2020/21, meaning:
  • most will be paid based on the 2018/19 achievement, while
  • those relating to diabetes and hypertension will be based on the 2019/20 achievement (given some were new in 2019/20).

These points will be subject to a list size and prevalence adjustment calculated in the usual way at year-end.

• The quality improvement (QI) domain will be paid to practices in full.
• To be eligible for income protection, contractors need to agree a plan with their commissioner that sets out how QOF care will be delivered wherever possible, but with priority according to clinical risk and accounting for inequalities.
• All activity should continue to be coded and aspiration payments will ‘continue as at present’.
• QOF payments may be made later than usual for 2021/22 given that the proposed changes to the scheme are being made towards the end of the year.
• QOF will recommence in full from April 2022.

Investment and Impact Fund (IIF)

• The three flu immunisation indicators and the appointment categorisation indicator will continue as was originally planned, however, the remaining indicators shall be placed on hold.
• £62.4m of the funding for these suspended indicators will be distributed to PCNs through a PCN support payment and on a weighted patient basis.
• The next steps to be taken by PCNs are to confirm that the monies will be reinvested into service or workforce.
• The IIF will continue as was initially envisaged by the DES from April 2022.

Tackling Neighbourhood Health Inequalities service

• The deadline for PCNs to engage a priority cohort in the Tackling Neighbourhood Health Inequalities service has been extended to 28 February 2022.

What you need to do next

• If your practice is currently signed up to the 2021/22 DES, you must enter into a written variation of the primary medical services contract with the commissioner.
• If your practice is enrolled, we encourage you to review your PCN Network Agreement to ensure it reflects the updated 2021/22 DES.
• The deadline for PCNs changing their membership or for practices signing up or backing out of the DES; has now passed (19 January 2022).

How Capsticks can help

Our primary care team has advised and supported GP clients on the establishment of our 100 PCNs across the country. This includes advising on structural options and network models, drafting a tailored and bespoke Network Agreement for each PCN and advising on workforce, employment and HR.

If you would like any further information about the actions you need to take in light of the DES 2021/22, our experts can offer you a Network Agreement Health Check to make sure you are on track. For further information, please contact Mark Jarvis or Neha Shah to find out more about how Capsticks can help.