Four new PCN service specs delayed as 2021/22 GP contract revealed

Four new primary care network (PCNs) service specifications will be delayed due to the need for ‘pandemic prioritisation’, the BMA has said.

The BMA today unveiled details of this year’s updates to the GP contract, which it said includes ‘minimal changes’ to provide practices with ‘support and stability’ through the Covid pandemic.

NHS England and the BMA’s GP Committee have agreed funding increases for practices and PCN staff, including as part of QOF and the Additional Roles Reimbursement Scheme (ARRS), the BMA said.

PCNs will have increased funding to hire paramedics and will have ‘flexibility’ to be able to hire a ‘wider range of staff’, including community mental health practitioners.

There will be ‘minimal changes’ to QOF, except those previously agreed and ‘minor changes’ to existing modules to ‘account for the impact of the pandemic’, the BMA said.

Further QOF funding will back physical health checks for patients with serious mental illness, it added.

However, the BMA said a decision is ‘yet to be made’ on which parts of QOF will be implemented from April and will depend on the ‘pandemic situation at the time’.

Meanwhile, a new obesity and weight management service and funding will be considered ‘within the year’, the BMA added.

And funding commitments already made will be honoured, it said.

The controversial personalised care and anticipatory care services – which were first delayed last year  – and those covering tackling inequalities and CVD diagnosis and prevention will no longer be introduced in April as planned.

However, the previously agreed uplift in ARRS funding – from a maximum of £430m in 2020/21 to a maximum of £746m in 2021/22 – will go ahead.

Meanwhile, inner and outer ‘London weighting’ will be added to the maximum ARRS reimbursement amounts per role so that PCNs in the London region will be able to offer new staff competitive salaries.

This will be ‘reinforced’ through the DES for 2021/22 rather than an increase to London ARRS funding or reduction in ARRS allocations elsewhere, the BMA said.

In a letter to GPs, the BMA said: ‘PCNs in London have faced an additional recruitment challenge in not being able to offer the same inner and outer London weighting that is available to other NHS staff in London. 

‘NHS London may now offer this on top of maximum current ARRS reimbursement amounts.’

The BMA added that the contract arrangements will remain ‘under review’ and further changes will be agreed during the year.

These will depend on the pandemic situation and the ‘progress of the Covid vaccination programme’, but practices will be given ‘reasonable notice’ of any changes, it added.

BMA GP committee chair Dr Richard Vautrey said: ‘Given the unprecedented pressures on general practice and the wider NHS – not least in delivering the largest vaccination campaign in history  – now is not the time to introduce major contractual changes. 

‘What’s needed is stability, reassurance and support, allowing GPs and their teams to focus on the most pressing tasks at hand.’

He added: ‘We are therefore glad to have secured an agreement with NHS England to hold off on any significant changes or requirements from April, while continuing to support practices and their patients through the most challenging period of the pandemic so far.’

The BMA will ‘continue discussion’ with NHS England and ensure that any changes later in the year ‘deliver the best for general practice and their patients’, he said.

It comes as the BMA today announced its GP Committee will be able to continue negotiating the terms of the PCN DES with the backing of 80% of GPs.