NHSE: Prioritisation and resourcing in general practice


Prioritisation and resourcing in general practice

We want to remind practices of the position around prioritisation and resourcing at this difficult time and to facilitate delivery of COVID-19 vaccination. General clinical prioritisation is something that practices are used to managing. In these particular circumstances additional steps have been taken as below:

  1. We announced on Monday the availability of £150m of re-prioritised capacity funding ring-fenced to support general practice to deliver at this time. This is not to be diverted by systems for wider purposes.
  2. Local enhanced services should where possible be re-purposed by agreement with CCGs to make funded capacity available for COVID 19 vaccination.
  3. Extended Access and hours capacity should similarly be reprioritised to provide additional capacity [as above].
  4. QOF has been significantly income protected around long term condition management activity. Practices should approach the management of long term conditions on the basis of clinical prioritisation and should continue to record patient contact but this will not impact payment.
  5. QI modules in QOF have been significantly revised, supporting essential activity.
  6. Additional Roles Reimbursement Scheme (ARRS) staff can be deployed as required to vaccination as integral members of PCN teams. ARRS recruitment should continue with full funding entitlements remaining in place to continue to support practice teams.
  7. PCNs should note that the Structured Medication Review and Medicines Optimisation service requirements in the Network Contract DES are very clear that the number of SMRs to be delivered will be determined and limited by PCN clinical pharmacist capacity. Depending on local clinical prioritisation it is likely to be the case that COVID vaccination is considered a priority for deploying available clinical pharmacists in the short term.
  8. A PCN may use its Additional Roles Reimbursement Sum to reimburse extra hours worked by PCN staff, at plain time rates only, as long as the increase in WTE hours worked is clearly recorded on the PCN’s claim form and National Workforce Reporting System.
  9. Further information will follow in due course about how PCNs can access further support from local systems to bring in additional workforce to support the Covid-19 vaccination programme.
  10. Whilst a restart of a new, more supportive appraisal model was described in a letter from Stephen Powis earlier this year, we fully recognise the current pressures on the system and the need for a  flexible and sympathetic approach - many areas will not be in a position to carry out appraisals at this time but we will maintain the ability to access support for those who need it.
  11. CQC have separately communicated about their approach to ease burden on providers in this period.

Nikki and Ed