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PCN incentive scheme to include online GP consultation targets from October


online consultation targets


The network incentive scheme will measure the number of online consultations PCN member practices carry out from October, new guidance has revealed.

And PCNs will be measured against two-week wait appointment targets from next year, it added.

It comes as NHS England has announced that the controversial PCN anticipatory and personalised care services have been deferred until next year, with the other two services due to start from October this year in a ‘reduced’ form.

In new guidance published yesterday, NHS England set out the Investment and Impact Fund (IIF) indicators that will reward PCNs for service specification work they complete in both 2021/22 and 2022/23.

It said that this year, PCNs will be measured against a target for ‘online consultations’ of five per 1,000 patients per week from 1 October, with 27 IIF points worth £6.1m available.

This number of online consultations per 1,000  registered patients will continue to be measured in 2022/23 – when it will decrease to 18 points worth £4.1m – but the threshold is yet to be decided, it added.

The IFF guidance said that PCNs will be rewarded through the voluntary scheme for achieving ‘continued delivery of online consultations’.

It said: ‘Indicator ACC-02 ensures that online consultations continue to be offered to patients consistently across the country as we exit the pandemic, relieving pressures on wider services as part of the recovery programme.’

PCNs will also be rewarded for ‘improvements in patient experience of access to general practice’ through incentives based on performance measured with a ‘forthcoming survey-based real-time measure of patient experience’, it said.

From 2022/23, PCNs will also be measured on the ‘percentage of patients who had to wait two weeks or less for a general practice appointment’ in an indicator worth 71 points and £16m, the IFF guidance said.

This will reward GPs for ‘reductions in rates of long waits for routine general practice appointments, which are a leading cause of dissatisfaction with primary care services and can result in the escalation of clinical needs’, it added.

NHS England said it will ‘keep under review whether further contractual requirements are needed to guard against the creation of perverse incentives for practices to refuse to book appointments more than two weeks in advance’.

The IFF will also measure:

  • The mean number of patient contacts as part of weekly care home rounds per care home resident in 2021/22 from October and in 2022/23
  • The number of emergency admissions per 100 care home residents in 2022/23 to reward PCNs for ‘moderating’ the number of admissions

And PCNs will be measured on the ‘follow-up’ of patients with one-off high blood pressure readings to ‘confirm or exclude’ hypertension in both years, as well as the resulting rate of hypertension diagnoses.

The guidance said: ‘An estimated 3 million people have a recorded reading of high blood pressure (BP) on GP systems, but have not had appropriate follow up to confirm or rule out a hypertension diagnosis. 

‘This issue is expected to have been exacerbated during the pandemic.’

Meanwhile, an accompanying document outlining new service requirements said that PCNs must ‘improve the identification of those at risk of atrial fibrillation’ through ‘opportunistic pulse checks’ when checking blood pressure from 1 April 2022.

All PCN clinical staff must also complete a mandatory thirty-minute online ‘refresher’ training on shared decision making by 30 September 2022, it added.

In a letter summarising the new requirements, NHS England confirmed that despite the delayed introduction of services, the IIF will be worth £150m in 2021/22 and £225m for 2022/23 ‘as previously set out’.

It added that it will PCN clinical directors rather than commissioners will be ‘primarily’ responsible for ensuring that IIF income is ‘re-invested wherever possible in services and staff, for example extra GPs and practice nurses’. 

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 to be included within a DES 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.

Last year, the introduction of the PCN incentive scheme was delayed due to the pandemic, with the money redistributed elsewhere.

But in September 2020, NHS England confirmed the IIF would be fully rolled out from the following month.

And in March, NHS England said ‘no further’ IIF indicators will be introduced until 1 October 2021 ‘at the earliest’.

READERS' COMMENTS [8]

Patrufini Duffy 25 August, 2021 5:53 pm

Open your eyes before “they” shut them completely.

Dr N 25 August, 2021 5:55 pm

Every normal GP I know is switching off online consultations. They create demand not solve it.

helen towner 25 August, 2021 9:55 pm

People should have been given a yearly allocation of e-consults to use–say 5—to prevent those who have been using them on a weekly basis and expecting a GP response for each–sure why to sink General Practice.

Michael Mullineux 25 August, 2021 10:18 pm

The PCN project becomes ever more attractive with each Kafkaesque ‘guidance’ from NHSE Command and Control …

David Church 25 August, 2021 10:50 pm

That’s no good – it is a measure of local patient demographics, but quality of GP services!

David Church 25 August, 2021 10:51 pm

PS – why does the local GP Practice have to answer every e-consult within 24 hours, even if it is not urgent?
surely 2-3 days would be adeqaute?

Andrew Jackson 26 August, 2021 12:28 pm

@DC
we put econsults in the next available appointment as if the patient has rung in. If this is a week or two then that is when it is dealt with
there is no queue jumping
The patient does receive an initial reply with the date that it will be dealt with so they can then approach us like any emergency situation if this is too long

Guy Wilkinson 26 August, 2021 1:09 pm

micromanagement via PCN, Another NHSE brainfart.