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Pilot PCNs to receive 10% funding uplift to expand GP clinical capacity

by Eliza Parr
27 June 2024

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PCNs taking part in a new pilot scheme will receive a 10% funding uplift for more GP clinical staff to ‘accelerate’ delivery of the long-term workforce plan.

The scheme is designed to test whether implementing the plan, along with other digital tools such as process automation, can plug gaps in general practice capacity.

Between 15 and 20 ‘test sites’ across England will gather extensive data over the next three years in order to understand whether these interventions make a difference compared with the current ‘baseline’.

Last month, NHSE announced that seven ICBs will oversee a PCN pilot scheme in order to test new ways of working in GP practices and build on delivery of the 2022 Fuller stocktake.

A recent information pack for GPs, seen by our sister publication Pulse, laid out the national plans in more detail, revealing that it will run until the end of March 2027, and will provide test sites with three streams of funding. 

PCNs, or PCN-size groups of practices, will receive funding for ‘more clinical capacity’, which will ‘accelerate’ the test sites to the 2028/29 long-term workforce plan model.

The information pack said the test sites will receive funding to ‘expand clinical capacity by 10%’.

It is not clear which part of the £2.4bn long-term workforce plan test sites will deliver on, given that its ambition is to increase GP training places by well over 10% by 2028, from 4,000 to 5,000.

NHS England has been asked to clarify how the pilot PCNs will align with the long-term workforce plan and whether the expanded clinical capacity will include both GPs and other professionals. 

The extra funding will come through the GMS contract and the PCN DES, and in an example given for a 50,000-patient PCN, practices would receive £300,000 for 2024/25 and £1.1m in 2025/26.

ICBs will also provide funding for other interventions, which will be agreed upon with PCNs, such as digital tools for ‘risk stratification’ or ‘repetitive process automation’ to reduce admin.

To build on the Fuller stocktake, NHS England also wants participating PCNs to explore ‘best practices’ for proactive population health management and for the care of complex or frail patients. 

ICBs will support PCNs by ‘co-ordinating resourcing for MDTs’, such as provision for a consultant geriatrician. 

Practices involved will be expected to carry out an audit to collect key data every eight weeks, and to help resource this, ICBs will provide funding to ‘compensate for intensive and iterative data collection exercises’.

The programme, which is described as a ‘before and after study’, will begin in September with data collection to commence the following month. 

The outline plan said: ‘There are many areas where better data could inform both local and national policies/ strategies’, such as addressing the gap between demand and capacity, the “optimal use” of ARRS staff, and ‘how to get the benefits of both scale and small teams’. 

The pilot ‘aims to fill many of these gaps’ and ‘support a path to a more sustainable future for general practice’. 

In order to take part, PCNs must have implemented the ‘modern general practice access’, as stipulated by the primary care recovery plan, and must have ‘no remedial contract notice or breach in the last 12 months’. 

The outline plan for the pilots is: 

  1. Establish a baseline of demand, resource, costs and economics for each test site by conducting a three-week long data collection exercise.
  2. Then ‘accelerate’ the test sites into 2028/29, with a range of interventions, digital tools and expanded clinical capacity to align to 28/29 long-term workforce plan.
  3. Then run ‘audit weeks’ to collect key data for quality improvement purposes.

This study will give NHS England the ‘ability to calculate any capacity gap in the 28/29 model’. 

Earlier this month, NHSE’s chief executive Amanda Pritchard said these pilots will be ‘integral to the future of the NHS’ and that a ‘modern vision for primary care’ is needed. 

But BMA GP Committee England chair Dr Katie Bramall-Stainer has criticised the pilots, and urged GPs not to take part, in her recent speech at the UK LMCs conference.

What the pilots seek to establish

  • How large is any gap between general practice demand and capacity?
    • Is the long-term workforce plan implied 28/29 capacity sufficient to close the gap?
  • How do variations in practice income impact levels of clinical capacity?
    • How much of GMS and PCN DES income is allocated to clinical/admin/managerial capacity?
  • What are the other drivers of variation in clinical capacity? (e.g. skill mix, primary/secondary care interface)
  • Which interventions should be prioritised nationally to help close any demand-capacity gap?
  • What drives variation in patient experience today, and what are best practices? (e.g. differing workforce skill mix, digital methods)
  • What drives variation in staff satisfaction today, and what are best practices?
  • What are best practices to maintain/improve continuity as GP model evolves?
    • What is the optimal measure for it?
    • How to organise clinical staff
    • How to leverage digital methods
  • What is the variation in spending across ICBs on primary care services?

Source: Somerset ICB webinar on 16 June 2024

A version of this article was first published by our sister publication Pulse