A new enhanced service worth a total of £30m is being offered to GP practices to support patients diagnosed with long Covid. Here Pulse Intelligence provides a summary of the requirements and payment mechanism for the new service.
NHS England’s enhanced service (ES) specification document says the new service is to ‘commission GP practices to enhance their training and infrastructure to enable them to better support patients with long Covid’.
It notes that general practice plays a key role in supporting patients (both adults and children) with long-term symptoms of Covid-19, which includes assessing, diagnosing, referring where necessary and providing longer term holistic support of patients.
The new service is therefore being offered to practices in recognition that this is a new and complex condition that requires professional education, consistent coding of patients, planning of clinical pathways and measures to reduce the risk of inequity of access to support.
The term Long Covid is used to describe:
The additional funding is for GP practices to plan their workforce set up, training needs and infrastructure to support patients with the condition – on top of their global sum funding, which ‘reflects their core contractual responsibility for the provision of essential services to this cohort’.
The service officially start on 1 July 2021 and ends on 31 March 2022 (unless terminated earlier).
Practices should receive an invite to participate by 8 July 2021 and must sign up on or before 31 July 2021 (unless their commissioner agrees otherwise).
Patients (with either previously confirmed or suspected previous Covid-19) may present in general practice with a wide range of symptoms including breathlessness, fatigue, chest pains, cognitive impairment or psychological symptoms.
The initial role of the GP or other clinician is to exclude acute or life-threatening complications and other unrelated diagnoses.
Assessment may include blood tests, chest X-rays or clinical tests, including sit-to-stand or lying and standing blood pressure (in line with NICE/SIGN/RCGP guidance) and advice, treatment or referral may be required.
Where a mental health condition is identified as the main symptom, support and/or treatment should be considered in line with existing local mental health pathways.
If ongoing symptomatic Covid-19 is diagnosed (from 4 weeks after infection) patients can be offered:
The service specification provides a more detailed treatment pathway algorithm, while further details on the clinical pathway and role of general practice are provided in national commissioning guidance.
Practices are required to ensure staff have the knowledge to identify, assess, refer and support patients with long Covid. This will involve:
*Coding includes:
GP practices are required to undertake a self-assessment to confirm the following is in place:
Practices will be paid just under 50p per registered patient on their lists, with three-quarters of the payment delivered up front, and the remaining quarter paid upon completion of the self-assessment part.
The document stresses the payment is ‘in addition to the funding already available to practices through global sum which reflects their core contractual responsibility for the provision of essential services to this cohort of patients’.
*based on list sizes at 1 January 2021.
Source: NHS England. Enhanced service specification: Long COVID 2021/22. Published 21 June 2021
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