NHS England published their letter to all primary care services (28th February) outlining the GP contract arrangements for the upcoming financial year, with changes aimed at improving primary care services, enhancing patient outcomes, and empowering Primary Care Networks (PCNs). We take a look into the key contents of the letter, summarise the important points, and discuss potential implications for ARRS funding, primary care staffing, and general budgets for primary care services in the UK.

Key Changes for 2024/25

The letter highlights several key updates and initiatives that will impact GP Practices and primary care services in 2024/25:

Changes to QOF points and targets : The changes to QOF in 2024/25 are a big shift towards “streamlining and reducing bureaucracy” in primary care. With 32 out of the total 76 QOF indicators being income protected, practices will now be awarded QOF points based on their past performance for these indicators, reducing the burden of meeting current year's performance targets.

This change intends to simplify QOF requirements, enhance efficiency, and allow practices to 'focus' on delivering high-quality patient care rather than administrative tasks. NHS England say that he selection of indicators for income protection has been 'carefully assessed' to ensure that patient outcomes are not compromised, reflecting a strategic approach to improving the QOF framework and ultimately enhancing the overall quality of care provided by GP Practices.

PCN Funding : The PCN Clinical Director and PCN Leadership and Management Payment will be consolidated into core PCN funding, totalling £183m. This consolidation aims to provide PCNs with greater autonomy and enable PCN Clinical Directors to lead their PCNs according to local arrangements.

Staffing Flexibility : PCNs will have more staffing flexibility, including the inclusion of enhanced nurses in the Additional Roles Reimbursement Scheme (ARRS) and the removal of all caps on other direct patient care roles for PCNs and GPs.

Simplified DES Requirements : Practices and PCNs will be supported to improve outcomes through the simplification of Directed Enhanced Service (DES) requirements.

Capacity and Access Payment (CAP) Increase : The CAP will increase by £46m to £292m by retiring three Investment and Impact Fund (IIF) indicators. This increase aims to support practices and networks in developing innovative delivery models and meeting local patient priorities.

QOF Aspiration Payment : The QOF aspiration payment threshold will be raised from 70% to 80% in 2024/25 to help improve practice cash flow.

Investment and Impact Fund (IIF) Streamlining : The IIF will be streamlined by reducing the number of indicators from five to two. Funding from retired indicators will be redirected into the CAP to further support practices.

These new contract arrangements are significant changes that aim to streamline processes, increase funding, and enhance staffing flexibility within primary care services. These changes are designed to empower PCNs, improve patient care, and simplify administrative burdens for GP Practices. The increased focus on funding allocation, staffing flexibility, and outcome improvement reflects a commitment to enhancing the quality of care provided by primary care services in the UK.

Issues Affecting ARRS Funding, Primary Care Staffing, and General Budgets

While the outlined changes in the GP contract for 2024/25 bring positive enhancements to primary care services, there are potential implications that may impact ARRS funding, primary care staffing, and general budgets for primary care services

ARRS Funding : The inclusion of enhanced nurses in the ARRS and the removal of caps on direct patient care roles may lead to increased demand for funding within PCNs. This could potentially strain ARRS budgets if not carefully managed and monitored.

Primary Care Staffing : The increased staffing flexibility within PCNs is a positive step towards enhancing patient care. However, ensuring adequate training, supervision, and resource allocation for new roles will be crucial to maintain quality care delivery without overburdening existing staff.

General Budgets for Primary Care

The changes in funding allocations, including the increase in CAP and streamlining of IIF, may impact general budgets - Practices and PCNs will need to adapt to these changes and ensure efficient use of resources to meet the evolving needs of patients and communities.

NHS England presents these 2024/25 GP contract arrangements as a promising outlook for primary care services in the UK. By focusing on funding allocation, staffing flexibility, and outcome improvement, these changes aim to enhance the quality of care provided by GP Practices and PCNs.

However, careful consideration of potential challenges related to ARRS funding, primary care staffing, and general budgets will be essential to ensure sustainable and effective delivery of primary care services in the coming year.

Do you think this new contract will give primary care a boost in 2024? Let us know in the comments below.