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Update to GP Contract 20/21 - 23/24

NHS England GP Contract Documents

2021/22 Contract

End of year Checklist 21/22 -  Once again, we have experienced a very unusual year with many contract changes, variations and activities stood up and down which all makes year end very tricky. Please see our checklist to help with this, we are aware there may be variations between areas and would suggest the document can be used as a guide

December 2021 - Temporary Contract changes and Income Protections

NHSE October 21 - Our plan for improving access for patients and supporting general practice. This has not been recieved well and the BMA has rejected the plan and can be read on the BMA website.

NHSE published a letter on 23rd August 21 with PCN plans for 21/22 - 22/23. This details the NHSE plan for the gradual introduction of new service requirements for PCNs and confirming how PCNs will access the funding available for their activities through the IIF across the second half of 2021/22 and 2022/23. The main implementation focus is 2022/23 rather than 2021/22, so that PCNs have the maximum possible time to prepare. In addition, NHSE also confirm new funding for PCN leadership and management support, of £43m in 2021/22.

Recognising current pressures in general practice, service requirements will not be introduced in full from October 2021, but phased over the coming eighteen months in a gradual way.

  Requirements in 2021/22 Requirements in 2022/23
Cardiovascular disease (CVD) prevention and diagnosis From October 2021, the requirements on PCNs will focus solely on improving hypertension case finding and diagnosis, where the largest undiagnosed prevalence gap remains and where the greatest reductions in premature mortality can be made. Requirements on PCNs to increase diagnosis of atrial fibrillation, familial hypercholesteremia and heart failure will be introduced from April 2022.
Tackling neighbourhood health inequalities PCNs will be asked to work from October 2021 to identify and engage a population experiencing health inequalities within their area, and to codesign an intervention to address the unmet needs of this population. Delivery of this intervention will commence from March 2022. Continued delivery of the co-designed intervention
Anticipatory care   Introduction of requirements for this service are deferred. By 30 September 2022, PCNs will be required to agree a plan for delivery of Anticipatory Care with their ICS and local partners with whom the service will be delivered jointly – in line with forthcoming national guidance.
Personalised care Introduction of requirements for this service are deferred. From April 2022 there will be three areas of focus for personalised care: further expansion of social prescribing to a locally-defined cohort which are unable or unlikely to access through established routes; supporting digitised care and support planning for care home residents; and shared decision making training.

Extension of the suspension of Friends and Family Test Returns

NHSE confirm (December bulletin 165) The temporary suspension of the requirement that practices report to commissioners about the Friends and Family Test (FFT) Returns has been extended until the 31 March 2022.

NHS 111 Booking into General practice

NHSE Update (Sept 21 Bulletin 153) During the pandemic a temporary change was made to the requirement for practices to make available to NHS 111 one appointment per 3000 registered patients to one appointment per 500 registered patients. This temporary change stopped at the end of September 2021 and the contractual requirement will revert to 1:3000.

January 2021 - GPC England have supported the agreement the BMA have secured with NHSE/I for minimal contract changes for 2021/22 whilst retaining the significant increases in funding already planned. There was a further update letter for QOF  10th March 21. Some of the previous agreements due to start in April will be delayed. This is to give practices support and stability through the continued pandemic and whilst practices are playing such a significant role in the COVID-19 vaccination programme.

Some of these changes will be implemented throughout 2021/22 depending on the pandemic, and will be agreed later in the year.
Practices will then be provided with adequate time to prepare.

The recordings of the recent GPC  GP contract 2021/22 update webinars are now available, including question and answer sessions. There is also a slide set to accompany the webinars that can be downloaded here

Further details are available on the BMA website, but in summary, from April 21:

WEIGHT MANAGEMENT ENHANCED SERVICE SPECIFICATION 2021/22   (Please click on the image below for our Summary of Key Points) NHSE have also produced a GP Toolkit for the NHS Digital Weight Management Programme.


LONG COVID SERVICE SPECIFICATON 2021/22   (Please click on the image below for our Summary of Key Points)

Vaccination & Immunisation

NHSE also sent an update letter specific to vaccination and immunisation changes for 2021/22. From 1 April 2021 the provision of vaccination and immunisation services will become an essential service for all routine NHS-funded vaccinations with two exceptions:

There will be five core contractual standards will be introduced to underpin the delivery of immunisation services. These are described in more detail in Annex A of the letter.

A single item of service fee (IOS) will be fully implemented for all doses delivered in vaccination programmes funded through the GMS contract - More detail in Annex B (of above letter)

The Childhood Immunisation Target DES will be retired on 31 March 2021 and a new vaccination and immunisation domain in the Quality and Outcomes Framework (QOF) introduced for 2021/22. The vaccination and immunisation indicators in this domain were referenced in the  letter of 21 January 2021.

Contract Resources and Documents

NHSE have provided a useful GMS Ready Reckoner that can be used for both practice and PCN puposes.

NHSE Quality and Outcomes Framework (QoF) Guidance for 2021/22

NHSE  have published the QOF Quality Improvement (QI) reporting templates for 2021/22

The RCGP  continues to support general practice carry out this QOF activity by producing learning material for the QOF QI module topics supporting people with learning disability and early diagnosis of cancer. Additionally, guidance has been produced to support effective and sustainable QI within a primary care network (PCN). These resources are available on the RCGP’s website.

Practice Index have also published QOF guidance for 21/22 and included a table on the new IOS reimbursements arrangements. The LMC also assisted with the table and think you may find it helpful.

NHS Digital - QoF Busness Rules - This webpage also includes details on business rules for enhanced services, vaccs and imms and also indicators no longer in QOF.

NHSE General Practice Pay Transparency: Guidance

Primary care system development funding (SDF) and GPIT funding guidance: Analysis of programmes and funding in 2021/22

This guidance outlines all the funds available to primary care via regions, systems and CCGs, including workforce growth and development, technology and practice and PCN resilience and development. This large and vital investment in primary care will help to support general practice both now, as the onus shifts to recovery, and in the future.

New to Partnership Payment Scheme (N2PP) This is a new commitment from the February 2020 ‘Update to the GP Contract agreement 2020/21–2023/24’, forming part of the suite of interlocking GP recruitment and retention initiatives. See for further details

General Practice Fellowship Programme   It is a two-year programme of support, available to all newly-qualified GPs and nurses working substantively in general practice, with an explicit focus on working within and across a Primary Care Network (PCN). Further details are available at:-

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Updated on Friday, 7 October 2022 18238 views