With all that is going on at the moment it can be difficult to keep up with financial updates, of which, at this time of year, there are many. To help we have pulled together the financial changes from the GP Contract for 2020/21 into a single article for you to refer back to. Below we start with the headline announcements and finish with the usual annual changes.
New Partnership Payment
To help with recruitment of partners, from April 2020 first time partners will be offered a guaranteed one-off payment of up to £20,000 per full-time partner and £3,000 of business training allowance to support them as a new partner.
This payment is initially in the form of a loan and only converts to a permanent payment after a fixed period of time as a partner.
From October 2020 contractors and sub-contractors are required to submit self-declarations annually if their NHS superannuable earnings are over £150,000 per annum – starting with 2019/20 in February 2021.
This threshold will rise each year in line with predicted CPI rises giving an expected threshold for 2020/21 of £153K and 2021/22 of £156K
Premises Costs Directions
Commissioners can now award improvement grants funding up to 100% of project value.
Primary Care Networks
Further to the revised network contract DES 2020/21 there has been further updates relating to the COVID-19 pandemic which have resulted in specific changes to the DES
Full details of the changes can be found here
PCN service specifications per the revised DES have been reduced and improved with the network participation payment continuing to be paid at £1.761 per patient.
The core £1.50 PCN Funding per registered patient continues into 2020/21 and will be based on patients registered as at 1 January 2020.
The additional roles reimbursement scheme has also now added the following:
- Pharmacy technicians;
- Care co-ordinators;
- Health and wellbeing coaches;
- Podiatrists and
- Occupational therapists
All additional roles are to be reimbursed at 100% (subject to the maximum reimbursable amounts) which frees up the £1.50/head core funding to contribute towards management support.
Investment and Impact Fund
The introduction of this new fund has been postponed for at least 6 months and a letter from NHS England and NHS improvements suggests £16.25m of funding earmarked for this will be recycled into a PCN support funding stream which will be paid on the basis of a PCN's weighted population at 27p per weighted patient for the six-month period to 30 September 2020.
Care Home Premium
A new care home premium payment worth £120 per bed per year will be introduced for PCNs within the Enhanced Health in Care Homes service specification from 30/9/20. This is worth £60 per bed in 2020/21 based on a half-year specification. Where a LES/LIS already exists for a service that is duplicated by the DES requirements, no decommissioning of that service by the CCG should take place until the DES requirements commence.
It has been noted that care homes services and the enhanced health in care homes service is important to the COVID19 response and will continue in line with the dates set out in the 2020/21 GP contract deal but NHS England and NHS Improvement will ensure alignment with COVID-19 pathways.
NHSPS Employer Contribution Rate for 2020/21
This remains at 14.38% for 2020/21 including the 0.08% admin levy, with the 6.3% difference contributed centrally.
The payment per weighted patient increased in April 2020 from £89.88 to £93.46 an increase of 3.983% or £3.58 per patient. This is higher than the uplift seen this time last year of just 92 pence per patient which was lower than normal following the introduction of the Government state-backed clinical negligence scheme.
Quality Outcomes Framework
The value of QOF funding has again followed the increase in the National Average Practice List Size which increased from 8,479 patients to 8,799 with the value of a QOF point increasing from £187.74 to £194.83.
From April 2020 QOF points have increased from 559 to 567 with a new indicator on non-diabetic hyperglycaemia worth 18 points. Asthma, COPD and heart failure domains have also had 97 points recycled into 11 more clinically appropriate indicators. This increases the average QOF funding by around £1,500 a year.
NHS England have also confirmed that they will undertake a piece of analysis to confirm the impact of COVID-19 on QOF Achievement for 2019/20 and will make a one-off adjustment for practices who earned less in 2019/20 than 2018/19 as a result of COVID-19 activities. They will also protect 2020/21 QOF income as necessary.
MPIG and Seniority payments
We are not expecting to see any MPIG or seniority income for practices from April 2020 onwards with the previous funding now all reinvested into the Global Sum.
With seniority, there may still be adjustments made up until 2024 for under or overpayments as entitlements have been based on interim seniority figures and final seniority figures are usually up to 4 years in arrears.
Vaccinations and Immunisations Changes
This has now become an essential service for 2020 and new contractual core standards will be introduced.
Item of service payments will be standardised for the delivery of each dose of all routine and annual vaccines at £10.06, fixed for the remaining three years of this contract deal.
This will also apply to routine vaccines which are given outside of the routine schedule where clinically indicated so will apply to MMR vaccines from 2020/21 and should be extended to other vaccines from 2021/22.
Childhood Target Payments
From 2021 the current Childhood Immunisation DES will be replaced by new incentive payments as part of QOF for achieving specified levels of population coverage. For routine schedule vaccinations this incentive will operate at practice level and form part of a new QOF domain which will reward incremental improvement in performance unlike the current dual threshold-based approach of the Childhood Immunisation DES (70% and 90%).
Currently practices achieving a combined coverage of less than 70% earn nothing from the Childhood Immunisation DES. As part of the changes, where practices are not achieving a minimum of 79% coverage on their routine childhood vaccines this will trigger a repayment of a proportion of earnings using the formula: value of the Item of service fee x 50% of eligible cohort size.
In effect for every patient vaccinated after the first 50% of their eligible population practices will earn the full £10.06 Item of service fee.
As part of the transition a baseline calculation of achievement will be completed in 2020/21 and the repayment arrangements will commence in April 2021 giving practices 1 year to prepare for the introduction of the scheme. It is anticipated that practices will be paid an aspiration payment on a monthly basis with a final balancing payment at year end which reflects actual achievement and any repayments, in a similar manner to QOF payments.
This funding moved into the network contract DES from July 2019 and will be paid based on patients registered on 1 January 2020.
Finally, we trust the above has been a useful resource and if you would like to setup a call or even a video conference with our team, please feel free to get in touch.