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A new agreement updating and amending the five-year contract which came into force in 2019, will come into force on April 1st, 2020. The headline changes are as follows:

  • A new Global Sum value of £93.46 per patient
  • A new QOF point value of £194.83.
  • More roles added to the Additional Roles Reimbursement Scheme, with the expansion of the scheme to 26,000 additional roles between 2020/21 and 2023/24
  • All roles to be reimbursed at 100%, freeing up the existing £1.50/head to contribute to management support for PCNs.
  • Funding entitlements to increase from £257m to £430m next year and, in 2023/24, from £891m to £1.4bn.
  • Extra investment to fund new GP training, recruitment and retention measures with £20,000 plus training support for every new partner.
  • Reformed payment arrangements for vaccinations and immunisations.
  • Updated QOF.
  • Reduced and improved PCN service specifications.
  • New Investment and Impact Fund, worth £40.5m in 2020/21.

 Below, we look at the key points in more detail.

 Expanded Additional Roles Reimbursement Scheme

 More roles are now added to the Scheme from April 2020, at the request of Primary Care Network (PCN) Clinical Directors. PCNs can now choose to recruit from the following roles within the Scheme, in addition to those previously agreed, to make up the workforce they need: pharmacy technicians, care co-ordinators, health coaches, dietitians, podiatrists and occupational therapists. Between 2020/21 and 2023/24, the scheme will expand to 26,000 additional roles.

 Full Reimbursement for All Additional Roles


Reimbursement now increases from the current 70% to 100% for all the above roles, freeing up the existing £1.50/head to contribute to management support for PCNs.

 For the average PCN in 2020/21, that means around seven Full Time Equivalent (FTE) staff, rising to 20 FTE staff in 2023/24. Assurances made under this deal mean PCNs can recruit fully, without worry about the theoretical risk of future employment liability and redundancy costs.

 Extra investment for new GP Training, Recruitment and Retention

Extra investment will fund new GP training recruitment and retention measures: GP trainee numbers will increase from 3,500 to 4,000 a year from 2021, with 24 months of the 36-month training period spent in general practice, from 2022. The Targeted Enhanced Recruitment Scheme (TERs) will be expanded from 276 places now, to 500 in 2021, and 800 in 2022, encouraging GP trainees to work in under-doctored areas.

To boost the GP partnership model, from April 2020, the New to Partnership Payment guarantees first-time partners a £20,000 one off payment, plus £3,000 funding for business training.

Reformed Payment Arrangements for Vaccinations and Immunisations.

The payment model will be overhauled to support improved vaccination coverage. Vaccinations and immunisations will become an essential service in 2020. Item of service payments will be introduced and standardised across all routine programmes over the next two years, beginning with Measles, Mumps and Rubella (MMR) in 2020/21 and extending to other vaccines from April 2021.

 New incentive payments will be introduced to maximise population coverage as part of QOF, replacing the current Childhood Immunisation Directed Enhanced Service (DES).

Updated QOF

QOF will be further updated, with an overhaul of the Asthma, Chronic Obstructive Pulmonary Disease (COPD) and Heart Failure domains, recycling 97 points into 11 more clinically appropriate indicators. With the introduction of a new indicator on non-diabetic hyperglycaemia worth 18 points, this brings the total number of available QOF points to 567, with an increased value of £194.83 per point.

Investment and Impact Fund (IIF)

The new Investment and Impact Fund rewards PCNs for delivering objectives set out in the NHS Long Term Plan and GP contract agreement. Operating in a similar way to QOF, there will be eight indicators included in 2020/21, relating to seasonal flu vaccination, health checks for people with a learning disability, social prescribing referrals, and prescribing. The Fund will be worth £40.5m in 2020/21, increasing to £300m in 2023/24.

Revised PCN Service Specifications

Following consultation at the end of 2019, a number of improvements have been made to the PCN Service Specifications. Structured Medication Reviews and Medicines Optimisation, Enhanced Health in Care Homes and Supporting Early Cancer Diagnosis services will be introduced in 2020/21, with the remaining four service specifications – CVD diagnosis and prevention, tackling inequalities, personalised care and anticipatory care – delayed now until 2021/22.

As with last year’s contract, this is a further positive move forward for general practice, strengthening a framework that allows and incentivises the expansion of the workforce to ensure it can deliver these new services, and demonstrating the government’s unequivocal backing for the PCN model. With our experience in advising Primary Care Networks and our unique offering of operational practice management support services, our specialist medical team can provide you with the route-map you need to navigate the ever-changing primary care landscape.

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