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At a glance: All the temporary GP contract changes to support Covid boosters

GP contract agreement

A round-up of all the temporary changes made to the 2021/22 GP contract to free up practices for the Covid booster campaign.


  • 46 QOF points for new indicators will be reallocated as there is ‘no historic performance to use as the basis for income protection’ – including the eight points for the new 2021/22 cancer indicators, 20 points for the new 2021/22 mental health indicators and 18 points from the non-diabetic hyperglycaemia indicator introduced in 2020/21 – to ‘increase the total points available for the eight prescribing indicators’
  • The four vaccination and immunisation indicators, the two cervical screening indicators, the register indicators and the eight prescribing indicators will be paid based on practice performance
  • The remaining indicators will be income-protected ‘using a methodology very similar to the one applied in 2020/21’ – most will be paid based on 2018/19 achievement, while those relating to diabetes and hypertension will be based on 2019/20 achievement since some were new in 2019/20
  • Income-protected points will be subject to a list size and prevalence adjustment ‘calculated in the usual way at year-end’
  • Practices will need to agree with their commissioner a plan that will set out how QOF care will be delivered wherever
  • possible, but with priority according to clinical risk and accounting for inequalities to be eligible for income protection
  • The quality improvement (QI) domain will be paid to practices in full
  • All activity should continue to be coded and aspiration payments will ‘continue as at present’
  • QOF payments may be made ‘later than usual’ for 2021/22 ‘given that the proposed changes to the scheme are being made towards the end of the year’
  • The changes apply to all practices and QOF will recommence in full from April 2022

PCN investment and impact fund

  • The three flu immunisation indicators and the appointment categorisation indicator – ‘as the work is complete’ – will continue to be paid based on PCN performance in 2021/22
  • The remaining indicators will be suspended and the £112.1m in funding allocated will be ‘repurposed’
  • £62.4m of suspended indicators’ funding will be allocated to PCNs via a ‘support payment’ to be paid on a weighted patient basis, subject to confirmation from the PCN that it will be ‘reinvested into services or workforce’
  • £49.7m will be allocated to a new ‘binary’ IIF indicator, paid on the basis of all practices within a PCN being signed up to phase 3 of the Covid vaccination enhanced service as at 31 December 2021, remaining signed up until 31 March 2022 and ‘actively delivering’ the programme
  • Practices not signed up to the enhanced service would need to opt-in by 10 December 2021 and be assured to go live in early January to be eligible
  • Payment for this indicator will be made on a ‘registered list size basis after the end of the financial year’
  • If the commissioner agrees with ‘one or more practices that they should not participate’ in the enhanced service ‘as a result of wider access, performance or patient safety issues’ and in ‘exceptional circumstances’, then the PCN may still receive payment with those practices excluded from consideration
  • The payment ‘will not apply if any practice in the PCN otherwise declines to participate in the programme’
  • As with QOF, recording of all activity should continue but payment ‘may be made later than usual’ 
  • IIF will recommence in full from April 2022

Telephony support

  • NHSX has agreed a ‘time-limited offer’ with Microsoft for practices to use MS Teams telephony functionality, as part of the NHS England Winter Access programme
  • The solution will enable staff to use MS teams ‘to make outbound only calls independently of the existing telephone solutions’ until 30 April 2023 and will ‘free up the existing lines for incoming calls’
  • Practices will keep their current telephony supplier and associated number in place to support the receiving of calls
  • The offer is an additional component to the Microsoft Teams application currently provided and will increase telephone capacity at no additional cost to the practice
  • Practices must indicate interest, if they have not done so already

Other measures

  • Income protection for the Minor Surgery DES from 1 December until 31 March 2022 for practices participating in the vaccination programme, with monthly payments to be made matching the corresponding period in Dec 2018 to March 2019. No contract enforcement where ‘no activity is done’ under the Minor Surgery Additional Service during the same period, but any capacity released ‘must be redeployed to vaccination’
  • Routine health checks ‘on request’ for over-75s who have not had a consultation in the last 12 months and new patients may be ‘deferred’ from 1 December until 31 March ‘where contractors consider it clinically appropriate’ and they are taking part in the vaccination programme
  • An amendment to the Dispensing Services Quality Scheme reducing the requirement for medication reviews from a minimum of 10% of dispensing patients to 7.5% for 2021/22 – with practices asked to ‘prioritise’ patients considered ‘higher-risk’ or most likely to benefit from a review

Source: NHS England