How has funding for English practices changed due to COVID?

A lot has changed in general practice since the start of the pandemic – to help you, here is  a quick guide to cover some of the funding changes which impact general practice

Income protection

• Global sum will continue to be paid at the agreed rates for the whole of 2020/21.
• The Quality Outcomes Framework (QOF) has now been refocused; QOF income protection is in place for the vast majority of indicators and the two QI modules. The indicators not protected are those related to immunisations, screening and disease registry management.
• The minor surgery directed enhanced service will be suspended, and income protected, from 1 January until 31 March 2021. A similar provision is intended for the additional service income related to minor surgery within the global sum.
• CCGs have been instructed to suspend any locally commissioned services from 1 January until 31 March, except where these are specifically in support of vaccination, or other COVID-related support, with payments for practices protected.
• DSQS payments remain in line with the normal requirements.
• Investment and impact fund payments from October 2020 to March 2021 are based on achievement of the six indicators set out in the IIF guidance.

PCN clinical director payments

In recognition of the role of primary care network (PCN) clinical directors in managing the COVID vaccination response, further funding for PCN clinical director support will be provided until March 2021. This is equivalent to an increase from 0.25WTE to 1WTE for those PCNs where at least one practice is participating in the vaccination programme enhanced service. This funding will be able to be flexibly deployed by PCNs as required.

COVID-19 support fund

NHSEI released details of the additional £150m funding to support practices in England until 31 March 2021.

General principles

Funding is provided to cover additional costs of:

• bank holiday opening (for Easter and 8 May) including staff and non-staff costs;
• services to care home residents (from 1 May to 30 September);
• additional capacity (from 23 March to 31 July) where supported by the commissioner;
• additional consumable expenses, including PPE;
• absence cover from day one (from 23 March to 31 July). Practices which have provided full pay for employees who were unable to work will be able to claim the costs of cover.

Reimbursements will only be made where the additional costs are not offset by income protection. Practices will be required to submit evidence and assurances as part of claims, along with a declaration form which states that they are true additional costs in line with the rule laid out in the guidance.

Local commissioners will manage the claims process via S96 funding and must approve claims for funding. A post-payment verification process will require a sample of claims to be reviewed and verified.

Staff costs

Reimbursement will be made to cover all staff absences (from day one of absence to day 14 for GPs at the below rates and, thereafter, through the SFE provisions) and where full pay has been provided to the absent individual. The SFE provisions should still be used for non-COVID related sickness cover.

Reimbursement will be made to cover additional capacity within practices (and to maintain capacity to cover absence), as follows:

• additional locum cover will be provided at £200/session or £250/session for OOH;
• additional GP partner sessions will be provided at £289/session, up to two sessions per week per partner;
• additional existing salaried GP sessions will be made in line with contractual rates;
• additional temporary salaried GP sessions will be provided at £200/session or £250/session for OOH;
• additional work from other staff groups, whether to cover absence or to provide additional capacity, will be provided in line with contractual rates (for existing staff or temporary staff)

Reimbursement will also be made for applicable employer National Insurance and pensions costs for each of the above staff groups.

Consumables

• PPE costs are covered directly by DHSC; details of the process to be released soon.
• Minor physical adjustments to buildings (eg. Perspex screens and barriers) will be reimbursed.
• Additional cleaning materials will be reimbursed.
• Additional clinical equipment will be reimbursed.
• Other additional consumable costs will be down to commissioner discretion. 

What should your practice do now?

• Request information from commissioners about the claims process.
• Review additional costs already incurred and submit claims to the commissioner.
• Discuss with commissioners any anticipated further costs that might require approval.
• Keep careful records and evidence of additional costs.