Overview of changes in the 2022/23 GP contract in England

Earlier this week, NHS England announced the 2022/23 update to the GP contract. Here, we summarise the key points on what we know so far.

1. PCNs in England will need to offer routine services between 9am and 5pm on Saturdays from October as part of a new access offer within the network DES.

NHS England confirmed that the new ‘enhanced’ access offer will bring together the current £1.44 per head Network Contract DES extended hours funding and the current £6 per head CCG-commissioned extended access services into the PCN DES.

While the work for the CCG service will be brought into the PCN DES, NHS England is vague about whether the money that backed it will also be moved into DES.

The £1.44 is already part of the PCN DES, so if the £6 is brought in, PCNs would receive a total of £7.44 per head for delivering the service. If not, this would mean a significant drop in funding – perhaps meaning practices would be offering the service at a loss.

2. PCNs will need to provide a minimum of 60 minutes of appointments per 1,000 PCN-adjusted patients per week. Until now, the Network DES – like the extended hours DES before it – specified 30 minutes per 1,000 patients. This new offer is ‘based on PCNs providing bookable appointments outside core hours within the Enhanced Access period of 6.30pm-8pm weekday evenings and 9am-5pm on Saturdays’.

PCNs can also provide a ‘proportion’ of the required Enhanced Access minutes outside of these ‘network standard hours’ if this has been agreed with the commissioner – where it is ‘evidenced by the PCN that such appointments would better meet the needs of the PCN’s patients’.

NHS England said this could be through the provision of a morning clinic between 7am and 8am, or ‘by exception’ a proportion of capacity could be used to ‘support management of demand during core hours where this is regularly high’.

3. PCNs have been told they must offer ‘a range of general practice services, including routine services such as screening, vaccinations and health checks, in line with patient preference and need’. They have also been told they must provide bookable appointments for ‘any general practice services’.

4. PCNs have been told to ‘work with their commissioner to produce and agree an Enhanced Access Plan‘ to prepare for delivery of the service from 1 October. Plans must be submitted by 31 July with a final iteration agreed by 31 August.

5. NHS England has removed the contractual requirement that at least 25% of appointments are available for online booking. There will be a ‘more targeted requirement’ that all appointments that do not require triage are able to be booked online, as well as in person or via the telephone. More guidance will follow.

6. Minor changes to vaccinations and immunisations in 2022/23), include:

• For HPV there will be a transition from Gardasil 4 to Gardasil 9 during 2022/23, and a move from a three-dose schedule to a two-dose schedule (with doses given at least six months apart), for both those aged 15 and over, and for the national HPV MSM vaccination programme. A three-dose schedule will remain for those who are HIV positive or those who are immunocompromised
• There will be an end to the 10 and 11-year-old MMR catch-up programme and the requirement for practices to take part in one catch up campaign per year
• The Men ACWY Freshers programme will come to an end on 31 March 2022
• There will be a wider childhood immunisation campaign taking place during the early part of 2022 to support recovery of these programmes  aimed at capturing children that missed these immunisations due to the pandemic Practices will be asked to support uptake of routine childhood immunisations for 0 to 5-year olds and will receive the IOS payment of £10.06  per dose.

7. The £20m funding in the Global Sum to reflect workload for practices from Subject Access Requests will go on a year longer, continuing into 2022/23.

8. No new additional indicators will be added to QOF when the temporary income protection arrangements come to an end in March 2022. Quality Improvement (QI) modules for 2022/23 will focus on optimising patients’ access to general practice and prescription drug dependency

9. There will be another £280m available for PCNs to recruit additional staff under the additional roles reimbursement scheme. PCNs will continue to have flexibility to hire into any of 15 different roles. There will be a doubling of mental health practitioners roles to support people with complex mental health needs, plus additional flexibility to help support recruitment to these roles.

11. GP practices will be required to respond to Access to Health Records Act (AHRA) requests for deceased patients. However, the requirement for practices to always print and send copies of the electronic record of deceased patients to Primary Care Support England (PCSE) is removed. The savings from removing this requirement will ‘far outweigh’ the additional burden of managing AHRA requests, NHS England says.

Read NHS England’s letter on the 2022/23 GP contract changes in full here.

Based on reports produced in our sister publication, Pulse.