Updated: Dec 20, 2022
Supporting General Practice, Primary Care Networks and their teams through winter and beyond
On the 26th of September, NHS England released a letter and guidance document titled. Supporting general practice, primary care networks and their teams through winter and beyond, detailing plans for:
Additional resources and funding
Suspension of non-essential work for Primary Care Networks
Amendments to the Impact and Investment Fund
With so much going on, it's hard to keep up. So here is our compilation of the latest guidance, which will serve as a starting point for new PCN Managers and Clinical Directors.
In this blog, I choose a few highlights to focus on, but you will of course, need to read the document as every network is different and will prioritise different areas of the guidance.
In this blog, I will cover:
The ICB framework for supporting general practice.
Immediate changes to the Network Contract DES and provide some questions for consideration.
Changes to the Impact and Investment Fund.
I will also provide you with an action plan to help inform your next steps.
To support this blog, you will need to access the following resources:
Update 1 | The ICB framework for supporting General Practice
The purpose of this framework is to support integrated care boards (ICBs) and practices/ PCNs to determine where investment can be best targeted to enable rapid improvements.
Whilst many ICBs will already have some local intelligence and data on the points covered and can use this existing knowledge to complete the framework, many may not and may need your input and support in collating this information.
In a recent clinical strategy meeting with a PCN based in Kent and Medway who have commissioned the National Association of Primary Care to facilitate a workshop and conversations to ascertain how we were approaching
Population Health Management.
The data packs available and how we interpret and use them.
How we operate as a team.
The meeting took 30 minutes and included 2 Co-Clinical Directors, a Care Coordinator, and myself and coincidently covered many points in the framework, but we now need to revisit the unanswered questions in the framework.
🎯Action item 1
Use the framework presented in the document and answer the questions most pertinent to you. Even if this framework wasn’t in place, I think it’s a good exercise in business planning.
This is also a helpful exercise to ensure your team is on the same page and to identify what you need and how you can make this happen if resources can be made available.
Update 2 | Immediate changes to the Network Contract DES
Primary Care Networks can now recruit a GP Assistant role to help reduce the administrative burden for GPs.
Clinicians no longer have to undertake personalised care training.
The letter confirmed Primary Care Networks should continue to recruit and issue permanent contracts as ARRS recruited staff will be treated as part of the core general practice costs beyond 23/24.
We have the opportunity to Introduce a digital and transformation lead. The role will be capped at one per PCN, and the maximum reimbursement will be equivalent to an Agenda for Change band 8a.
The cap on hiring advanced practitioners (APs) through the ARRS has increased to two (and double for those with over 100,000 patients).
It has been confirmed that there will be an increase in the ARRS maximum reimbursement rates for 2022/23 to account for the Agenda for Change uplift.
🎯Action item 2 Questions / points for consideration
A) The GP Assistant
Would a GP Assistant role be of benefit, and how would this role work across the network?
Are you clear on the training requirements?
Where will you advertise? Universities, colleagues, can you speak to apprenticeship providers?
B) Advanced Clinical Practitioners
If you have already made the decision to invest in additional ACP’s in your network and pay the increase from practice funds. This will now be reflected in your ARRS reimbursement claim saving some money for your practices.
If you are looking to recruit an additional ACP, along with the traditional forms of recruitment, is there the opportunity to:
Promote from within the network?
Support someone to ACP status?
C) The Digital Transformation Lead
This appointment will largely depend on your PCN's existing business plans or as a result of you answering the sections in the ICB framework.
D) The increase in the ARRS maximum reimbursement rates for 2022/23
How will you communicate the pay increase to your teams?
Update 3 | Changes to the Impact and Investment Fund
The following IIF indicators have been deferred to 23/24:
The following thresholds have been reduced:
1. CVD-02 - Percentage of registered patients on the QOF Hypertension Register: Reduce from 0.6/1.2 to 0.4/0.8 percentage point increase
2. IIF PC-01: Percentage of registered patients referred to a social prescribing service. Reduce from 1.2%/1.6% to 0.8%/1.2%.
3. CAN-01 – Change permissible time between FIT result and referral from seven to twenty-one days.
4. CVD-04 expands the list of success criteria. See page 12.
The funding these indicators would have generated will now come to the PCN in the form of a PCN Support Payment to be paid monthly and based on the PCN’s adjusted population.
This payment is to be reinvested into the network in the form of increasing clinical capacity.
Using the questions for consideration in action 2 above, you may wish to meet with your leadership and management team and pursue the following lines of inquiry and
Discuss the changes and updates and assess what opportunities are potentially available to you regarding recruitment (review your workforce plan) and funded projects via the Primary Care system development funding (SDF)
Review the ICB framework and assess where you are in each area
Agree on how you will inform the network of changes relating to the IIF
Consider if there is an opportunity to speak with your staffing providers (if you have them) regarding service utilisation and the potential increasing provision
From here, update; you can then update your 90-day plan if you work to one, to help get everyone focussed and on track.
⛔️ Word of caution
The majority of change projects fail to meet their potential, so before embarking on any project, we must make sure there is buy-in from the practices.
Recruitment and training takes time.
Be crystal clear on why you are recruiting and what you want the post to deliver.
We hope this helps!
About the Author
I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast, where we have now published over 200 episodes. I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 PCNs by providing interim management, training and consultancy.
I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 250 blogs.
I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.
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