The introduction of the structured medication review (SMR) and medicines optimisation service specification – which fall under the PCN DES – will be postponed until October 2020 ‘in the first instance’, NHS England has said.
In a letter sent to GP practices today, NHS England medical director for primary care Dr Nikki Kanani and director for primary care strategy and NHS contracts Ed Waller said that the enhanced health in care homes service requirements will continue ‘in line’ with the GP contract as planned.
This specification was due to be brought in from October this year, and will continue, but this will be dependent on the efforts to fight the virus.
PCNs have been told to ‘make every possible effort’ to start work on the early cancer diagnosis ‘as planned, unless work to support the Covid-19 response intervenes’, NHS England said.
The introduction of an incentive scheme as part of the investment and impact fund (IIF) will also be deferred for ‘at least’ the first half of 2020/21, however ‘investment for the first two-quarters of 2020/21 will not be lost to PCNs’, the letter added.
Funding ‘attached to the PCN DES’ in 2020/21 will still be available to any practices that sign up to the DES, it said.
The letter said: ‘Networks should make every possible effort to begin work on the early cancer diagnosis specification as planned, unless work to support the Covid-19 response intervenes. People who are concerned about any symptoms related to suspected cancer should still contact their GP and GPs should make sure they continue to refer those for suspected cancer for diagnostic tests as normal.
‘Given the importance of delivering a coordinated service to care homes, the Enhanced Health in Care Homes service requirements will continue in line with the dates set out in the 2020/21 GP contract deal, and we will ensure alignment with Covid-19 pathways.’
It added that the deadlines to submit additional workforce planning templates will be delayed from 30 June to 31 August 2020 and the requirement for CCGs to redistribute unused additional roles funding to other PCNs will also be postponed until the end of September 2020.
The letter said: ‘The additional workforce under the ARRS will be critical to the Covid-19 response. However, we recognise that PCNs may need more time to consider their workforce needs.’
PCN clinical directors may also delegate ‘many of their functions’ to a non-clinician where appropriate ‘to free up capacity’ for their the response to coronavirus, the letter added.
It said: ‘The core PCN funding (£1.50/head) and clinical director funding may both be used to secure additional non-clinical support to the clinical director and to support the Covid-19 response.’
The BMA welcomed the measures but said that they ‘can only be the first step’ and warned that short-term suspensions are ‘unsustainable’.
BMA GP committee chair Dr Richard Vautrey said :’Whilst commitments to guarantee payments to practices in the coming year are important, practices expect bold and clear action, that gives them confidence to focus on the emergency at hand.
‘A short-term suspension of QOF and the PCN service specifications is unsustainable – Covid-19 will have a severe and prolonged impact on how general practice operates and in addition practices will need time to recover.’
He added: ‘The idea that it will be business as usual by October is not in line with the evidence and projections, not least as this could be the very time a second wave of infections starts to circulate.
‘These elements need to be suspended for the full year at least, and until practices are back on sustainable footing.’
NHS England chief executive Simon Stevens told MPs on the House of Commons health and social care committee earlier this week that aspects of the PCN DES ‘frankly will be a help to practices, not a hindrance’.