Introduction of controversial PCN services deferred until 2022/23

The introduction of the controversial PCN anticipatory and personalised care services has been deferred until next year, NHS England has announced.

The other two PCN services that were due to start from October this year – tackling CVD diagnosis and prevention and health inequalities – will be introduced in a ‘reduced’ form, it added.

NHS England also announced a further £43m PCN leadership funding for 2021/22, which will include an adjustment for areas of higher deprivation.

It comes after NHS England last week told the BMA it was considering the deferral of the four new PCN service specifications that were due to start in October.

In a letter to GP practices, published today, NHS England announced the ‘gradual introduction’ of new service requirements for PCNs in light of the ‘pressures’ facing general practice.

It said: ‘Taking into account the immediate pressures on general practice, and in line with NHS England’s letter to GPC England of 18 August 2021, we are now setting out a plan for the gradual introduction of new service requirements for PCNs and confirming how PCNs will access the significant funding available for their activities through the IIF across the second half of 2021/22 and 2022/23.’

It confirmed that the ‘main implementation focus’ will be 2022/23 rather than 2021/22 ‘so that PCNs have the maximum possible time to prepare’.

The letter said that the introduction of all requirements for both the anticipatory care and personalised care services will be ‘deferred’ until 2022/23.

However, it added that there will be three ‘areas of focus’ for personalised care from April 2022, including supporting ‘digitised care and support planning’ for care home residents.

And PCNs will be required to ‘agree a plan’ for the delivery of the anticipatory care service with their ICS and local delivery partners by 30 September 2022, in line with ‘forthcoming national guidance’, it said.

As part of the ‘phased’ introduction of new service requirements ‘over the coming 18 months’, the two specifications covering CVD and inequalities will be introduced in 2021/22 ‘in a reduced or preparatory form’, NHS England added.

It said: ‘From October 2021, the [CVD service] requirements on PCNs will focus solely on improving hypertension case finding and diagnosis, where the largest undiagnosed prevalence gap remains and where the greatest reductions in premature mortality can be made. 

‘Requirements on PCNs to increase diagnosis of atrial fibrillation, familial hypercholesteremia and heart failure will be introduced from April 2022.’

PCNs will also have to ‘identify and engage a population experiencing health inequalities within their area’ from October 2021 and ‘codesign an intervention’ to address their ‘unmet needs’, it added.

Delivery of the intervention will start from March 2022, it said.

Meanwhile, NHS England also said that PCN clinical directors ‘need further support’ to ensure PCNs have the ‘maximum impact’, widen participation across local partners such as community pharmacy and ‘play a key role making a success of ICSs’.

It added: ‘We will therefore provide new funding to support PCN leadership and management, of £43m in 2021/22. 

‘This funding will be allocated on the basis of the clinical commissioning group (CCG) primary medical allocation formula – therefore incorporating a specific adjustment for unmet need in areas of higher deprivation. It will be for clinical directors to recommend how it is deployed to create new capacity in support of the work of PCNs.’

The letter also said that PCNs will deliver a ‘single, combined extended access offer’ funded through the network DES from April 2022, with further details to be published ‘this autumn’.

This will allow for collaboration between PCNs as well as subcontracting to other providers such as GP federations and commissioners should ‘ensure that PCNs are preparing for this transition’, it added.

NHS England said the 2021/22 changes will be published in a revised DES to take effect from 1 October, with the 2022/23 changes and extended access requirements to be included within the DES for next year which will be published ‘later this financial year’.

Practices will be automatically enrolled into the revised DES if there are no changes to their PCN details but will have one calendar month to opt-out, it added.

Four extra PCN services – covering CVD diagnosis and prevention, tackling inequalities and the controversial personalised care and anticipatory care services – were due to be brought in as early as October.

But last month the BMA revealed it had met with health minister Jo Churchill, urging her to delay the four upcoming PCN services this autumn until April 2022 over workload concerns.

The original PCN contract required GPs to deliver five of the seven PCN service specifications in 2020/21, but the personalised care and anticipatory care services were delayed. The network services covering CVD diagnosis and prevention, and tackling inequalities were originally planned for introduction in 2021/22.