The GP contract regulations will be updated in 2022/23 with the intention of making a number of changes to be aware of
Online bookings
In light of the new models of access to general practice which have been developed during the pandemic, there will be a change to the existing contractual requirement that at least 25% of appointments are available for online booking. The existing requirement, currently drawn from the totality of a practice’s appointments, is felt to be too crude; it will be replaced with a more targeted requirement that all appointments which do not require triage are able to be booked online, as well as in person or via the telephone.
Guidance will be issued on what type of appointments practices are expected to make available for online booking.
The Access to Health Records Act
GP practices will be required to respond to Access to Health Records Act (AHRA) requests for deceased patients, and the requirement for practices to always print and send copies of the electronic record of deceased patients to Primary Care Support England will be removed. It is expected that the savings made from not having to print and send the electronic record will far outweigh the additional burden of managing a small number of AHRA requests.
Vaccinations and immunisations
There will be some minor changes to vaccinations and immunisations in 2022/23 which reflect forthcoming changes to the routine vaccination schedule recommended by the Joint Committee on Vaccination and Immunisation, including:
human papillomavirus;
MMR, including support for a national campaign;
MenACWY Freshers programme.
Funding
There will also be continuation of funding in Global Sum (£20m) for one additional year (2022/23) to reflect workload for practices arising from subject access requests. The original five-year deal had assumed that this funding would cease beyond 2021/22.
Modernisation
In order to support the modernisation of GP registration there will be a clarification of the ability for patients to register digitally.
QOF
No new additional indicators will be added to QOF when the temporary income protection arrangements come to an end in March 2022. The Quality Improvement modules for 2022/23 will focus on optimising patients’ access to general practice and prescription drug dependency. Approximately 97% of practices signed up to the Weight Management Enhanced Service in 2021/22 and this service will continue for 2022/23.
PCNs
Expanding primary care capacity remains a top priority, and PCNs have made excellent progress in recruiting to roles under the additional roles reimbursement scheme (ARRS); the national target is 15,500 FTEs by the end of 2021/22. Based on NHS Digital data, and NHS England and NHS Improvement ARRS financial returns, NHS England are confident that it is on track to achieving this target, and to achieving 21,000 FTE by 31 March 2023 and 26,000 FTE by 31 March 2024.
The amount available for PCNs to recruit additional staff will increase, as promised, by £280 million to just over £1bn for 2022/23. PCNs will continue to have flexibility to hire into any of 15 different roles. NHS England continues to encourage PCNs to make full use of their ARRS entitlements, including working with mental health providers to take advantage of the doubling of mental health practitioners’ roles to support people with complex mental health needs; such staff can be employed on a 50:50 shared reimbursement model. Additional flexibility to help support recruitment to these roles will also be introduced, including a broadening of the role outline to include non-clinical support for patients and the inclusion of Band 4 in the eligibility.
The PCN clinical director funding for 2022/23 has been agreed as £0.736 per head, or £44m nationally, as part of the five-year deal; NHS confirms that this funding will be boosted by a further £43m. PCNs will continue to be able to draw down the £1.50 per head core PCN funding, meaning that a total of £178m will be available for PCNs and their clinical directors to support core running, leadership and management in 2022/23.
As agreed in the 2019 deal, and subsequent updates, the two funding streams currently supporting extended access will be brought together, under the Network Contract DES, to fund a single, combined and nationally consistent access offer with updated requirements, to be delivered by PCNs. In this way, the current £1.44 per head Network Contract DES extended hours funding, and the current £6 per head CCG-commissioned extended access services, will be combined. This transfer to PCNs was delayed as a result of the COVID-19 pandemic and delivery will now start from October 2022, with preparatory work being undertaken from April 2022.
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 – and 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.
PCNs will be able to provide a proportion of enhanced access outside of these hours – for example, early morning or on a Sunday – where this is in line with patient need locally and it is agreed with the commissioner. NHS England and NHS Improvement have already set out, in August 2021, their plans for 2022/23 for PCN service specifications and the PCN Investment and Impact Fund. There will be a limited expansion of the Cardiovascular Disease Prevention and Diagnosis service; the Anticipatory Care and Personalised Care services will be introduced via a phased approach from April 2022.
NHS England is now further re-phasing its published plans in two ways:
Firstly, 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 implementation required by 31 March 2024.
Secondly, 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.
To find out more about the changes being made click here.
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