GP and PCN lead Dr David Coleman explains what the new Investment and Impact Fund involves and offers advice on how practices can best meet the goals to earn the maximum funding on offer
Revised details of the new achievement-based fund for Primary Care Networks (PCNs) were announced in September 2020.
The new start date for the Investment and Impact Fund (IIF) for 2020/21 was October 1st and it will run until March 31st.
Think of the IIF as a kind of Quality and Outcome Framework (QOF) for Networks; according to the NHS England guidance document on the IIF, the general objective is to ‘support primary care networks (PCNs) to deliver high quality care to their population’ but this year there is a heavy focus on the COVID-19 response.
How much is it worth?
The document states that ‘the IIF will be worth £24.25 million in 2020/21, rising to at least £150 million in 2021/22, £225 million in 2022/23 and £300 million in 2023/24’. So this is going to be a vital priority for PCNs for the foreseeable future.
Like QOF at a practice level, indicators are worth a number of points, with achievement being rewarded on a sliding scale between two thresholds. ‘Each PCN can earn a maximum of 194 IIF points and the value of a point will be £111.00 (adjusted for list size and prevalence)’.
This equates to £21,500 of IIF funding for an average PCN, which has to be reinvested ‘into additional workforce and/or primary medical services’.
What do practices have to focus on?
There are six indicators are divided into two key domains (thresholds detailed separately here):
2. Providing high quality care – personalised care and medicines safety (75 points)
Achievement is measured at a PCN level and progress can be monitored on a quarterly basis via a new digital dashboard.
With only 6 months to achieve the targets in 2020/21, the first quarterly check will be vital.
How should we approach the IIF?
Primary care is no stranger to incentivised targets and we are used to devising plans to achieve these at a practice level.
The key difference here is working with our neighbours. By now, PCN relationships should be well established. We may have differences in approaches, but a common ground will hopefully have been acknowledged.
To me, it makes sense for the Clinical Director to adopt the role overseeing IIF, although local arrangements could be made to allow another interested party, say a GP or practice manager from a member practice, to lead on this area; a compromise could be to backfill their time with additional hours from the ARRS workforce. The key is that the PCN should agree who will take responsibility.
As stated above, the critical point is maximising the initial and then the first quarter review of the data on the dashboard.
This will help the practices make the necessary push in these performance areas to maximise achievement. I would suggest IIF becomes a standing agenda item at monthly PCN meetings to encourage all practices to keep an eye on the ball.
Here are some additional thoughts and advice on the specific indicators:
PR01: Percentage of patients aged 65 and over who received a seasonal flu vaccination
HI01: Percentage of patients on the learning disability register aged 14 and over who received an annual learning disability health check
It is advisable to make sure there is a joint focus on the QOF QI tasks when addressing the IIF work too – while there is some overlap, they are not the same.
PC01: Percentage of patients referred to social prescribing
MS01, MS02, MS03: Gastro-protective prescribing
Dr David Coleman is a GP partner and PCN co-director in South Yorkshire
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