Updated: Dec 20, 2022
With so much going on, it's hard to keep up. So here is our summary of the latest General Practice Contract Arrangements for 2022/23 guidance required of Primary Care Networks, which was released on 1st March 2022. Our update will be a good starting point for brand new PCN Managers and Clinical Directors.
You can also hear the reactions on the General Practice Contract Arrangements for 2022/23
Covid -19 Vaccinations, Long Term Conditions, and More Additional Roles
As I write this, the systems are planning for:
Continued access to COVID-19 vaccination
Delivery of the autumn COVID-19 vaccination campaign if advised by JCVI
Development of detailed COVID-19 contingency plans to rapidly increase capacity, if required
As a result of this planning, primary care networks will be asked to carefully consider their capacity to deliver alongside resuming business as usual activity.
The document states that the primary focus of general practice will be to address non-COVID needs. In particular, this needs to be on long-term condition management and chronic disease control, ensuring timely access for patients with urgent care needs, and regaining momentum on the wider Long Term Plan prevention agenda.
Expanding primary care capacity will also be a priority.
PCNs have the “flexibility” to recruit to the following roles, however, there are some limitations on the number of certain roles and so please check the PCN DES:
Clinical Pharmacists (excluding Advanced Practitioner)
Advanced Practitioner (Clinical Pharmacist)
Dietitians (excluding Advanced Practitioner)
Advanced Practitioner (Dietitian)
First Contact Physiotherapists (excluding Advanced Practitioner)
Advanced Practitioner (Physiotherapist)
Occupational Therapists (excluding Advanced Practitioner)
Advanced Practitioner (Occupational Therapist)
Paramedics (excluding Advanced Practitioner)
Advanced Practitioner (Paramedic)
Podiatrists (excluding Advanced Practitioner)
Advanced Practitioner (Podiatrist)
Health and Wellbeing Coaches
Social Prescribing Link Workers
Trainee Nursing Associates
Adult Mental Health Practitioner
Children and Young Persons Mental Health Practitioner
Funding is increased nationally from £280 million to just over a billion for 2022/23 and moving forward, PCNs will also be able to recruit to non-clinical roles. More information is to be released to provide further direction on this.
More on Funding
(UPDATED TO REFLECT THE - Network Contract Directed Enhanced Service – contract specification 2022/23 – primary care network requirements and entitlements)
Funding wise, PCNs will recieve:
0.736 per registered patient for PCN Clinical Director Funding
£1.50 per head Core Funding
£0.720 by the registered list size for Extended Access Funding - This was orignially £1.44
£3.7654 multiplied by the PCN's Ajusted Population for Ehanced Access Funding
An increase in the ARRS budget (as described above)
A share of £62.4m of the funding allocated to the suspended IFF indicators via a PCN support payment. This is to be paid on a weighted patient basis, subject to a simple confirmation from the PCN that it will be reinvested into services or the workforce.
£120 Care Home Premium (Per Bed)
The Leadership and Management funds is £0.699 multiplied by the PCN's Ajusted PopulationNationally, the IIF has been uplifted from £150m to £260m to reflect the planned uplift of £75m, plus an additional £35m agreed for specific purposes. The value of an IIF point will remain at £200.
Please see page 73 in the the update DES found here.
The new enhanced access arrangements aim to remove variability across the country and improve patient understanding of the service. The new offer is based on PCNs providing bookable appointments outside core hours within the Enhanced Access period of 6.30pm-8pm weekday evenings and 9am-5pm on Saturdays, utilising the full multi-disciplinary team, and offering a range of general practice services, including ‘routine’ services such as screening, vaccinations and health checks, in line with patient preference and need.
Extended access comes into play from October 2022 and PCNs are to work with their commissioner to produce and agree on an Enhanced Access Plan. Details are in Annex B.
The Impact and Investment Fund
There are updates to;
Early Cancer Diagnosis service requirements - See Annex C
Cardio Vascular Disease – See Annex D
Structured Medication Reviews – See Annex D
Business as usual
The vaccination programme
Enhanced care in care homes
Recruiting using the Additional Role Reimbursement Scheme (ARRS)
Cardio Vascular Disease ( Plus the latest update )
Structured medication reviews (SMRs) ( Plus the latest update )
Early Cancer Diagnosis ( Plus the latest update )
Monitoring network performance
Local contracts and projects PCN are also delivering on:
Local development plans
Practice Incentives Program (PIP)
Local Incentive Schemes (LIS)
Enhanced Services (ES)
It can be helpful to pull the headlines of the latest updates into a slide deck to walk your network through the changes
In regards to the IIF investment fund, I tend to discuss these with the Practice Managers in our monthly PCN Practice Managers meeting, and then the updates are cascaded in their Practice Meetings
I would recommend a dedicated workforce planning and recruitment meeting to get a head start on recruitment moving forward. In this meeting, you may wish to consider:
What is working well?
What do we need to deliver on?
What data are we using to inform our decisions?
What do the line management and clinical supervision look like moving forward?
Salary reviews of existing staff
How are we keeping track of leave and appraisals?
The onboarding and induction process of new roles
Areas for improvement
4. Appoint PCN representatives to inform the extended access provision moving forward. Review your current provision. What is working well and what improvements can be made? What do your patients need and what capacity do you have and work collaboratively.
5. Review your PCN Finances. The should be a monthly activity
The PCN Clinical Director and management will share oversight over all of these elements.
Clinical Leads (if you have them) will tend to lead on specific areas.
In the pipeline
PCNs will have an additional year to implement digitally enabled personalised care and support planning for care home residents. 2022/23 will now become a preparatory year, with the implementation of the requirement required by 31 March 2024.
There will be an extension of the period that PCNs have to develop their anticipatory care plans until December 2022. The Anticipatory Care service itself, which will be ICS led, will start in 2023/24.
If you’re new to your PCN Manager role and are unsure of what is expected of you, please check out our PCN Accelerator Programme here.
If you are a new Clinical Director, please check out PCN Plus here
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Tara has an MBA in Healthcare Leadership and Management, is published in the London Journal of Primary Care, is the author of over 200 blogs also hosts The Business of Healthcare Podcast.
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