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QOF and IIF payments may be delayed, warns NHS England contract change letter

PCN funding

Payment for QOF and IIF ‘may be made later than usual’, NHS England has warned, as it set out the details of the temporary contract change aimed at freeing up GPs for Covid boosters.

In a letter sent to practices today, NHS England set out ‘temporary’ changes to the GP contract designed to support the expanded Covid booster programme, including outlining more details on the changes to QOF and the PCN IIF for 2021/22.

But it warned that QOF and IIF 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 temporary contract changes outlined that:

  • GPs should ‘focus’ on the four QOF vaccination and immunisation indicators, the two cervical screening indicators, the register indicators and the eight prescribing indicators, which will be paid based on practice performance.
  • 46 QOF points for new indicators ‘where there is no historic performance to use as the basis for income protection’ will be reallocated to ‘increase the total points available for the eight prescribing indicators’.
  • The remaining indicators ‘will be income protected using a methodology very similar to the one applied in 2020/21’.

The letter said: ‘Practices are expected to continue to apply their clinical judgement and deliver as much patient care in these areas as they can, with a focus on the highest risk patients, but their income will not be dependent on recorded QOF achievement this year for the income-protected indicators’.

The changes will apply to all practices and be reflected in an amended statement of financial entitlement (SFE), it added.

It said: ‘To be eligible for income protection, 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.’

NHS England will be working with the RCGP and the BMA to provide further guidance to practices, it added.

Meanwhile, the letter also set out changes to the PCN incentive scheme for 2021/22 – including that £112.1m funding for suspended indicators will be ‘repurposed’.

The three flu immunisation indicators and the appointment categorisation indicator will be paid based on PCN performance, while the remaining indicators ‘will be suspended and the funding repurposed’, it said.

It added that £62.4m will be allocated to PCNs via a ‘support payment’ to be paid on a ‘weighted patient basis’ and £49.7m will be allocated to a new ‘binary’ indicator paid on the basis of participation in the booster programme.

It reiterated that QOF and the IIF will restart in full from April 2022.

NHS England said: ‘We recognise that balancing your resources this winter between the urgent needs of your patients, the management of long term conditions, and the vital task of vaccination and public health is a daily challenge. 

‘The measures in this letter seek to support your professional clinical judgement in balancing these considerations.’

It added that the new measures will support, GPs, PCNs and their teams to ‘progress this expansion of the vaccination programme alongside prioritisation of timely patient access to general practice services this winter’.

Last week, NHS England revealed that parts of QOF and the IIF will be suspended and income-protected until April to free up GP capacity for delivery of the expanded Covid booster programme.

It also expanded on the increased ‘financial support’ in the form of raised vaccination fees announced earlier in the week.

The health secretary last week promised that the Government was working to ‘free up’ GP time so they can dedicate themselves to delivering Covid booster jabs.

GP leaders had called for GPs to be freed up to focus on speeding up the Covid booster jab campaign – including by suspending QOF – and for NHS England to ‘guarantee funding security’ for GP practices until the end of March.


Iain Chalmers 9 December, 2021 7:56 am

If HMRC penalise any late payment can we do same to NHSE??