Primary Care
As the entire system strives for greater patient care, better access and of course, improved efficiency, choosing which digital solution to explore and utilise can be a challenge.
Resources are limited, which one is the optimum solution for my organisation?
Naturally, we will suggest that the improvements we make to long-term condition management, and the impact this has on the wider organisation and regional system is the optimum choice, but that isn’t the purpose of this article…
Beyond making the right choices, it isn’t always clear how these services can be paid for, in regards to available NHS funding. This article details the various funding pots that PCNs can tap into for the provision of virtual care, to improve patient care and practice efficiency.
The Additional Roles Reimbursement Scheme (ARRS) has been around in England since 2019. It allocates funding to PCNs who recruit staff to one of 17 multi-disciplinary team (MDT) roles, many of which prove useful as part of a digital LTC care scheme.
Each PCN is allocated an annual pot of ARRS funding based on its weighted population share. You can then claim up to this maximum amount each year.
The exact amount you can claim depends on the ARRS staff you recruit and on where your PCN’s Core Network Practices are located – in Inner London, Outer London or the rest of the country.
For example, if your PCN in Inner London recruits a clinical pharmacist, you can claim an annual reimbursement of £72,269. This figure would be less – £62,340 per year – if you were based outside of London.
You can use ARRS funding to recruit a wide range of MDT staff, from Physician Associates to Pharmacy Technicians to Digital & Transformation Leads. Watch our recent webinar – Maximising the efficiency of ARRS roles – to discover more about how these roles can benefit your PCN.
Going forward, NHS England plans to “extend the success” of the ARRS scheme and increase the number of non-GP direct patient care staff by around 15,000 by 2036/37. But funding details are yet to be announced.
It’s therefore reassuring to know that ARRS isn’t the only funding pot for digital care initiatives within your PCN.
Full details of all ARRS roles and the reimbursement available to PCNs is available in the Network Contract DES specification.
PCNs are rewarded for meeting IIF targets.
For 2023/24, the majority of IIF funding goes towards Capacity and Access Payments (CAP), which we’ll cover in more detail below. But you can still access a funding pot worth £59.1m by achieving points in relation to five IIF indicators.
This year, indicators relate to tackling health inequalities, vaccination rates, cancer referrals and the percentage of patients whose time from booking to appointment is two weeks or less. There are 262 points across all indicators and each point achieved is worth £198.
The Capacity and Access Payment comes under the IFF umbrella, and consists of two parts:
The Capacity and Access Support Payment is worth £172.2m. This unconditional payment is allocated to each PCN based upon its adjusted population. For the 2023/24 period, this amounts to an average of approximately £137,000 per year and £11,000 per month per PCN.
New for 2023/24, there’s another part to CAP – a Capacity and Access Improvement Payment. The total fund is worth £73.8m.
If your local Integrated Care Board (ICB) judges that your PCN has made improvements in the following three areas, you’re entitled to some or all of this additional funding.
The three areas of improvement are:
So that improvement can be assessed, you have to work with your ICB to record base-level performance and then monitor progress across all of these areas. If you can demonstrate improvement or high levels of achievement across the year – and in all three improvement areas – your ICB will assess the value of funds to be released.
Payments are worth an average of £59,000 per PCN. Any money earned from the IIF funding pot has to be used for workforce expansion or primary care services.
You can find more information on CAP here: Network Contract DES – Capacity and Access Improvement Payment for 2023/24.
Different funding pots are available to GP practices, PCNs and – more recently – ICBs.
As well as baseline funding, ICBs receive service development funding (SDF). This SDF funding is designed to support initiatives that improve the quality of primary care. And it includes one allocation of £169.9m dedicated to primary care transformation.
PCN can join forces with other PCNs and make a proposal to their ICB, asking them to fund a primary care transformation initiative, such as a virtual LTC service.
Local enhanced services (LES) offer supplementary support to the core services provided by local practices. Developed by local commissioners, these services can vary across the UK as there isn’t a national agreement in place. This means the scope and funding of LESs can differ from region to region. Practices themselves have the discretion to adopt a LES. Some examples of enhanced services that have been commissioned in various parts of the UK include cardiovascular screening health checks, dementia diagnosis and pathways like Diabetes care, to name a few.
PCNs now have to provide enhanced access to services from 6:30pm-8pm, Mondays to Fridays, and from 9am-5pm on Saturdays. Fulfilling this part of the Network Contract DES equates to £7.578 for each of your PCN’s adjusted population.
Of course, practices can also use core PCN funding to invest in services such as virtual chronic condition care over the long term. PCNs receive £1.50 per registered patient per year. This equates to £0.125 per patient per month.
To work out the total available income for your PCN in 2023/24, you can use the Ready Reckoner spreadsheet provided by NHS England. Just enter your patient numbers and it will do the calculations for you.
As you can see, it’s not just ARRS. There are several different income and funding streams available to PCNs looking to create a virtual chronic care provision for patients.
Some funding is built into the PCN DES contract. Some is dependent on you meeting targets. And other funding pots require you to make a bid.
Whichever way you access it, it’s important to use available funding, such as ARRS, smartly and before any specified deadlines. There’s a “use it or lose” element to some funding streams. So by identifying and using them, PCNs and practices can not only bolster resources with a view to improving services and staff wellbeing, they can safeguard certain funding into the following financial year.
At Suvera, we’ve partnered with 120 GP practices across 9 ICBs. So we’re well-versed in helping our partners make the most of available funding, supporting them to better meet targets and boost patient care.
If you’d like to learn more about how Suvera’s virtual clinic can support your practice – or how you might secure funding for our services – just get in touch with our friendly team.