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Slashing the number of Investment and Impact Fund (IIF) indicators has undermined staff hired under the ARRS scheme, PCN directors have said of the new GP contract.
In its contract newly imposed on GPs, NHS England last week confirmed it would cut 31 of the IIF targets, leaving just five remaining, with a portion of the attached funding instead handed directly to PCNs.
However, PCN clinical directors have criticised the decision, flagging that many of the hires they have made under the ARRS were done in order to serve the indicators.
The indicators – which attached funding to a series of targets – often required specialised or non-GP staff on hand to properly fulfil them, clinical directors say.
Dr Geetha Chandrasekaran, clinical director for North Halifax PCN, said: ‘We have built teams around hitting IIF targets – especially when hiring clinical pharmacists. Cutting them now is a total knock-down of the years’ work and any clinical progress we may have wanted to make, such as when prescribing inhalers or conducting SMRs.’
And Dr Laura Mount, Central and West Warrington PCN clinical director, said: ‘I feel that it’s a shame that some of the evidence based IIF indicators which we have spent the last year training staff up on have gone.’
While it is currently unconfirmed which indicators will be dropped, NHS England did specify it will only continue those focussing on flu vaccinations, learning disability health checks, early cancer diagnosis, and – controversially – on two-week access.
The new contract also instructed that GP practices will have to offer patients an ‘assessment of need’ on first contact and will ‘no longer be able to request that patients contact the practice at a later time’.
Dr Kieran Gilmartin, clinical director for Fareham and Portchester PCN, flagged that PCNs are already offering enhanced access (EA), with many open 9-5 on Saturdays.
He said: ‘I suspect they may add targets and numbers to the requirement and tell us exactly how we should be doing it. I think that’s my concern.
‘The contract talks about an access improvement plan agreed with the Commissioners in quarter one. Quarter one starts in four weeks’ time and we haven’t got any other detail of this and at the end of March prior to that, ICBs will assess for ‘demonstratable and evidenced improvements in access to patients’ and then award funding. What’s classed as improvement in access for patients? Is that going to be Sunday or longer hours?’
Dr Gilmartin added that many PCNs offer EA in a way that works for individual PCNs, with additional uniform stipulations potentially rendering their plans unsustainable.