GP ContractQOFEnhanced ServicesPrimary Care Networks
COVID-19: BMA Guidance for GP practices on stopping non-essential work
The BMA has issued a series of guidance on what steps practices should take to manage the escalating coronavirus situation. Pulse Intelligence summarises the key points on activities practices can stop to help free up capacity, what to do on QOF now that this income is protected and what Network DES work to prioritise.
The BMA has advised that all ‘non-urgent’ work should be postponed until
further notice, and provides the following list of activities as examples:
and travel vaccinations
reviews of frailty
(non-essential to be suspended)
services quality scheme to stop (with funding protected)
medication reviews (essential ones to be conducted by phone)
non-urgent provision (DESs and LISs/LESs) to be postponed until further notice
be protected for practices
collection requests (unless considered essential to support the COVID-19
routine nurse appointments will be subject to telephone triage by nurses
CQC inspections (already enacted)
NHS England has said that QOF income will be protected for the duration of
the COVID-19 outbreak – with practices paid for 2019/20 in based on their QOF
submissions to date (with a top-up if this leads to a shortfall compared with 18/19
The BMA advises practices:
Care that is
clinically necessary, relevant and possible, should be delivered, primarily by
telephone or digital consultation.
income for 2019/20. Payments will be protected and made in-line with best of
2018/19 or 2019/20 achievements.
has committed that QOF income for practices for 2020/21 will be protected and
information will be provided as soon as possible.
Two of the three new service specifications (Structured Medication Reviews
and Enhanced Health in Care Homes) have been postponed for six months, but NHS
England wants practices to start work on the ‘Early cancer diagnosis’ service specification
from April, if possible.
However, the BMA is advising practices strongly to delay work on all these services to focus on their COVID-19 response. It states:
While NHS England
/ Improvement have stated that the cancer service specification will begin in
April, and the SMR (structured medication review) and care home specifications
could commence in October, work associated with these have no time limits or
targets and should be delayed to focus on COVID-19. GPC England believes it
will be necessary to suspend these service specifications for 2020/21.
The BMA further advises, in line with NHS England’s announcement:
director responsibilities may be delegated to others (including non-clinicians)
be protected and made in line with the contract agreement.
and investment fund) is on hold for at least six months, with the funding
retained for PCNs to use as they see fit.
expanded workforce you need using ARRS (additional role reimbursement scheme)
hours funding will continue but practices should work flexibly in response to
the current COVID-19 situation.
should prioritise COVID-related care first.
Activities to continue
The BMA advises practices to keep essential services going as well as
services as determined clinically relevant by the practice and based on the
available workforce, capacity and PPE.
for children, influenza and pneumococcal infection.
All staff are
covered by the full CNSGP (Clinical Negligence Scheme for General Practice
indemnity scheme currently.
Further guidance has been produced jointly by the RCGP and BMA, to advise
practices on what clinical work to focus on to ensure appropriate care is still
delivered to practice populations.