GP Contract QOF Enhanced Services Primary 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.

Activities practices can stop

The BMA has advised that all ‘non-urgent’ work should be postponed until further notice, and provides the following list of activities as examples:

  • travel advice and travel vaccinations
  • new patient reviews
  • over-75 health checks
  • minor surgery
  • clinical reviews of frailty
  • friends and family tests
  • engagement with PPGs
  • phlebotomy (non-essential to be suspended)
  • dispensing services quality scheme to stop (with funding protected)
  • dispensing list cleansing
  • routine medication reviews (essential ones to be conducted by phone)
  • all other non-urgent provision (DESs and LISs/LESs) to be postponed until further notice
  • funding will be protected for practices
  • audit and assurance activities
  • data collection requests (unless considered essential to support the COVID-19 efforts)
  • all other routine nurse appointments will be subject to telephone triage by nurses
  • appraisal and revalidation
  • all routine CQC inspections (already enacted)
  • all non-essential paperwork.

QOF activities

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 payments).

The BMA advises practices:

  • Care that is clinically necessary, relevant and possible, should be delivered, primarily by telephone or digital consultation.
  • Guaranteed income for 2019/20. Payments will be protected and made in-line with best of 2018/19 or 2019/20 achievements.
  • NHS England has committed that QOF income for practices for 2020/21 will be protected and information will be provided as soon as possible.

Network DES

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:

  • Some clinical director responsibilities may be delegated to others (including non-clinicians) as appropriate.
  • Payments will be protected and made in line with the contract agreement.
  • IIF (impact and investment fund) is on hold for at least six months, with the funding retained for PCNs to use as they see fit.
  • Recruit the expanded workforce you need using ARRS (additional role reimbursement scheme) funds.
  • Extended hours funding will continue but practices should work flexibly in response to the current COVID-19 situation.
  • Practices should prioritise COVID-related care first.

Activities to continue

The BMA advises practices to keep essential services going as well as routine immunisations.

  • Essential services as determined clinically relevant by the practice and based on the available workforce, capacity and PPE.
  • Immunisations 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.

Source: BMA – COVID-19: steps for GP practices to take

Guide URL:
XYou have free access remaining to read.

You have reached your limit of free access to articles.

Please login to access all guides.

Or, please register for a free trial to access all of the guides and unlock all features.