This guidance applies to England only.
The PCN (primary care network) DES (directed enhanced service) commenced on 1 April 2020.
The climate and the pressures have changed significantly since the original specifications were agreed, in response to this GPC England has produced this guidance to support practices to work together.
We encourage all practices to take part in the DES to provide structure in the national effort to deal with COVID-19.
NHSE/I have indicated that some of the service specifications have been postponed for a period of time. Realistically general practice will not be in a place to work on these fully this year.
We suggest that practices, working together where possible, focus on providing good care for patients whilst acknowledging that COVID-19 is going to take up most of our workforce and resources in the coming months.
This should apply to the three specifications that were due to be introduced this year:
- structured medication review and medicines optimisation
- enhanced health in care homes
- early cancer diagnosis.
Extended hours access
Capacity to provide extended hours access is going to fluctuate.
Focus needs to remain on staff and patient welfare and must not be compromised by efforts to deliver the specified hours in the DES.
- It is not realistic or appropriate to work long days.
- Appointments can be delivered remotely and by other healthcare professionals.
- The payment of £1.45 per patient will be made to the PCN to be passed on to practices.
Investment and impact fund - PCN support payment
The IIF (investment and impact fund) is suspended until 1 October 2020 and is and the equivalent fund of 27p per weighted patient for this period will be paid to PCNs directly. This is now referred to as the PCN (SP) support payment.
The IIF will commence from October, and be based on performance in relation to the IIF indicators set out in the 2020/21 GP contract. Further details and any amendments to indicators will be released shortly.
ARRS (additional roles reimbursement scheme)
If PCNs or practices have made arrangements to recruit staff or are considering recruiting staff in the coming months, you should continue with this. The ARRS funding is protected for this.
While ARRS funding is important, it is not the only support to deal with the COVID-19 outbreak and this is something we are urgently working with NHS England and NHS Improvement on.
Additional support should also come through the return to practice schemes for recently retired GPs and additional funding to practices to support flexible recruitment of essential workforce.
Whilst the requirement to postpone the submission of the workforce plans has been postponed until the end of August, it is likely that this will become an academic exercise as the situation then is going change.
PCN clinical directors
The work burden on clinical directors is likely to have increased significantly. The main focus of this should be to support constituent practices to deal with COVID-19.
Some of the non-clinical functions should be passed on to other staff, such as practice managers, so that the clinical director role focuses mainly on clinical functions.
Network participation payment
The payment of £1.761 per weighted patient will be made to the practices.
Core PCN funding
The core payment of £1.50 per patient will be made to the PCN.