New changes to the PCN contract have signalled a move towards practices delivering vaccinations ‘collaboratively’ across the network.
The PCN Network DES for 2024/25 includes a new clause which allows practices to administer vaccinations to patients from another practice within the PCN or from sites other than its own premises.
At the end of last year, NHS England outlined a plan for vaccinations to become part of a ‘one-stop shop’ with other health checks, and for PCNs to lead vaccination programmes rather than individual practices.
The long-awaited strategy aimed for vaccinations to become a ‘fundamental part’ of PCN-level integrated neighbourhood teams, as described in the Fuller Stocktake the year before.
It also suggested an end to the current GP practice enhanced services and QOF targets, with ICBs set to take over population-level management.
NHS England set out a timeline for implementing this strategy, with ‘some commissioning and contracting changes’ expected in 2024/25 – these new changes to the PCN DES appear to be a step in this direction.
The PCN contract also now makes explicit reference to integrated neighbourhood teams, saying PCNs should ‘collaborate with non-GP providers to provide better care’.
If practices decide to deliver vaccinations collaboratively, the PCN must ensure they sign on to a specific agreement setting out the arrangement.
The new clause on vaccination
A Core Network Practice may collaborate with other Core Network Practices in the following ways:
- administering vaccinations to eligible patients of other Core Network Practices;
- sub-contracting the administration of vaccinations to a patient to a person employed by another Core Network Practice;
- administering vaccinations to patients from a site other than its practice premises; or
- a combination of the above.
For any vaccination session delivered collaboratively, the PCN must ‘nominate a lead practice’ which will ‘be responsible for the operation of that session’ including ordering and holding the vaccines.
Beyond these stipulations in the national PCN contract, practices can set their own terms locally for how collaborative delivery will work.
This includes details of where the vaccination session will take place, how patients will be kept informed, organising any transportation of vaccines, and ensuring ‘appropriate staffing arrangements’.
The contract also said practices can decide their own arrangements for reporting vaccination data for income purposes, including the provision of reporting information to any practices that ‘may need to claim for payment for its registered patients’.
NHS England explained that the changes aim to allow more flexibility for vaccinations to take place conveniently, with the change requested by primary care organisations.
NHS England has also been working towards aligning Covid-19 and flu vaccination payments, with flu payments currently paid to practices directly and Covid payments to PCNs.
Former health secretary Sajid Javid had previously signalled plans for a move to a ‘national vaccination service’, to ensure GPs were not asked to stop routine care again, as they did during the Covid vaccination programme.
This led to GP concern about the impact of potentially losing vaccination services, with a ‘serious loss of income’ for practices, however so far no national vaccination service has been designed.
READERS' COMMENTS [3]
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More fragmentation and eventual further defunding of GMS as this progresses especially with non GP providers cherry picking select GMS services. Also more confusing system for patients with multiple sites, often not local so obstructive to achieving targets. Collaborative working often under delivers and the best hub is and should be a local one stop shop GP practice.
Please remember that the PCN is a contract and not an entity.
The PCN contract can be lifted away from practices and given to other providers to run – e.g. community services and hospitals etc. The reason it hasn’t happened yet is that NHSE doesn’t want to spook practices and reveal its intentions.
Once all this historic practice work (and associated funding) has been shifted from practice delivery to PCN delivery, practices are extremely vulnerable. They stop being masters of ‘their’ PCN, and start being its servants.
Next step will be DESs and then LCSs, then PCNs will start taking on GMS/PMS/APMS contracts from ‘failing’ practices, and then it is game over.
Agree with the above having been apparent from the outset of PCNs and as has been previously noted, the progressive destruction of General Practice and Primary Care has been and is being spearheaded by PCN Clinical Directors.
If PCN Clinical Directors were to refuse their own personal benefits and monetary gains over the years in payment for leading this NHS Primary Care catastrophe and refuse to act as CDs, the dismantling of General Practice and destruction of young aspiring GP careers would be halted preventing further damage or at least be decelerated.