Network DES Contract updates – PCN services to be ‘phased in’

NHS England announced a series of updates on the Network DES Contract this week, including the phased introduction of PCN services over the next eighteen months. Here Pulse Intelligence provides a summary of the key points.

Areas of focus

NHS England has set out five areas of focus for the rest of 2021/22 and 2022/23, as follows:

1. Improving prevention and tackling health inequalities in the delivery of primary care
2. Supporting better patient outcomes in the community through proactive primary care
3. Supporting improved patient access to primary care services
4. Delivering better outcomes for patients on medication
5. Helping create a more sustainable NHS.

It has set out a number of changes to the DES for the rest of this year as well as updates from April 2022 onwards, as outlined below.

Changes for 2021/22 will be incorporated into a revised Network Contract DES to take effect from 1 October 2021. Practices will be auto-enrolled into the revised DES (unless their PCN details have changed) but will be given one month to opt out of the contract.

The 2022/23 changes will be included within the 2022/23 Network Contract DES.

Extra PCN management funding

To deliver on the above and widen participation of PCNs in their communities, NHS England has pledged an extra £43m to support PCN leadership and management in 2021/22.

The funding will be allocated based on CCG primary medical allocation formula, adjusting for unmet need in deprived areas. PCN clinical directors will be in charge of deciding how the funding is used to expand capacity to support their work.

PCN services

The four remaining PCN services yet to be implemented – cardiovascular disease prevention and diagnosis, tackling neighbourhood health inequalities, anticipatory care and personalised care – will no longer be implemented in full from October 2021 as previously planned.

Instead two services – cardiovascular disease prevention and diagnosis and tackling neighbourhood priorities – will be introduced in a ‘reduced or preparatory form’, while the other two services will be deferred until next year.

In summary, the services will be introduced as follows:

Cardiovascular disease prevention and diagnosis

2021/22 requirement: From October 2021, practices will be expected to start on improving hypertension case finding and diagnosis.

2022/23 requirements: From April 2022, practices will also be tasked with increasing diagnosis of atrial fibrillation, familial hypercholesterolaemia and heart failure.

Tackling neighbourhood priorities

2021/22 requirement: From October 2021, PCNs are asked to identify a population experiencing health inequalities, and then ‘codesign’ an intervention to address the unmet needs of this population. Then from March 2022, PCNs expected to commence delivery of their intervention.

2022/23 requirement: PCNs will continue to deliver their intervention.

Anticipatory care

2022/23 requirement:By 30 September 2022, PCNs have to agree a plan for delivery of Anticipatory Care with their ICS and local partners – in line with ‘forthcoming national guidance’.

Personalised care

2022/23 requirement:From April 2022, PCNs will focus on three aspects:

• Further expansion of social prescribing to a locally-defined cohort which are unable or unlikely to access through established routes;
• Supporting digitised care and support planning for care home residents; and
• Shared decision making training.

Extended access

From April 2022, PCNs will deliver a single, combined extended access offer funded through the Network Contract DES. Details expected ‘this autumn’ to allow for planning, ready to start the service. PCNs will be able to collaborate and/or subcontract the service to other providers, including GP federations.  

Investment and Impact Fund (IIF)

NHS England has set out full details of the IIF indicators for 2021/22 and 2022/23. As previously set out, the scheme is worth £150m in 2021/22 and £225m in 2022/23.

Many of the indicators in 2021/22 are designed as preparatory work – either towards the PCN service requirements or the introduction of full performance indicators in 2022/23.

Read our separate summary on the IIF indicators here.

Source: NHS England letter. Primary Care Networks – plans for 2021/22 and 2022/23. Published 23 August 2021