Government confirms new practice-level reimbursement scheme only covers salaried GPs

The new practice-level reimbursement scheme will only cover salaried GPs, Government documents have confirmed.

As part of this year’s imposed GP contract, NHS England said it would ‘repurpose’ £292m from PCNs to fund ‘a new practice-level GP reimbursement scheme’ to ‘enable practices to recruit new GPs’ or ‘increase the number of sessions from GPs already working in the practice’.

As exclusively revealed by Pulse earlier this week, GP leaders raised concerns that the scheme could be ‘prohibitively narrow in scope’ and only include salaried doctors.

Details of the scheme have now been published as part of an amendment to the statement of financial entitlements (SFE).

The amendment said that practices are entitled to make a claim under the scheme in relation to one or more of the following:

• the employment of ‘a new salaried GP’
• the ‘increased participation’ of an existing salaried GP
• where the contractor is a core network member of a PCN ‘to enable the continuation of employment or engagement of a salaried GP’ previously funded through Capacity and Access Payments

The SFE said that the scheme applies from 1 April this and has effect in relation to the current financial year.

Practices with more than 3,500 patients per GP must seek approval from NHS England to be eligible to participate in the scheme, the document added.

It also said that total claims per contractor under this scheme are subject to a financial entitlement cap of £4.57 multiplied by the practice adjusted population per practice during the financial year.

The money to fund the scheme will be ‘repurposed’ directly from PCN Capacity and Access Payments, which included incentives for PCNs to identify patients who would most benefit from continuity of care.

While some GPs welcomed the transfer of funds to the GP practice level, others warned reallocating and ringfencing the money in this way could be ‘disastrous’ for PCN finances and more restrictive for practices. 

As the SFE amendment was published today, the Association of Independent Specialist Medical Accountants (AISMA) warned that GP practices operating in some of England’s most deprived areas ‘could miss out’ on funding through the scheme.

AISMA board adviser Andy Pow said: ‘Reimbursement is going to be linked solely to employing additional salaried GP sessions, which means that reimbursement for additional work performed by partners or locums will not be covered.

‘This will impact smaller practices, rural and coastal practices which already have difficulty recruiting additional GP staff due to their location or size. We could see some of our most deprived communities missing out on funding for more doctors.’

Reimbursement claims must be made via the CQRS system within a three-month window which Mr Pow said will increase administrative workload and also risk non-payment if the window is missed.

He added: ‘This is part of an increasing trend to narrow the time frame for claiming income which puts an increased risk on practices. Cashflow will also need to be managed since claims can only be made in arrears.

‘Many practices and PCNs used Capacity and Access funding which has now ceased. There is no transitional support to wind down previously funded activity. This leaves practices and PCNs at risk of carrying the burden of unfunded costs.’