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Update to GP Contract 20/21 - 23/24

NHS England GP Contract Documents

2021/22 Contract

BMA Update April 2021 - NHSEI has confirmed that the temporary changes to the GP contract under the pandemic regulations which were due to lapse at the end of March have now been extended until 30 June 2021.

As with previously, this means:

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:

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

NHSE Quality and Outcomes Framework Guidance for 2021/22

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.

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.

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.


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.

2020/21 Contract 

There was a further letter on 7th Jan 2021 from NHSE entitled "Freeing up practices to support COVID vaccination" (and an update to this letter to clarify with further details on 3rd Feb 2021). The letters further amended the previous contract requirements (as below) with added income protections. This includes income protection for QOF QI and prescribing indicators, meaning the vast majority of QOF is now income protected, income protection for minor surgery for this quarter, a direction to CCGs to suspend LESs and to take a supportive pragmatic approach to contract management, and crucially, providing additional funding to support the work of PCN clinical directors and those who have worked so hard in the initial delivery of the COVID-19 vaccination programme, with an increase in payments from 0.25 WTE to 1 WTE for those PCNs where at least one practice is taking part in the vaccination programme. We have created a webpage to detail the changes made through 20/21 during covid-19.

NHSE published a letter with the revised updates to the GP Contract for 20/21 that come into force on 1st October.

The QOF (2020/21 General Medical Services (GMS) contract Quality and Outcomes Framework (QOF) Guidance) element of the contract, for the remainder of 2020/21 has since been revised in light of Covid-19. The BMA have produced the following helpful brief summary: -

• support practices to reprioritise aspects of care not related to COVID-19
• serve those patients most in need of long-term condition management support
• guarantee significant income protection and the relaxing of some requirements for practices.

There are 567 points available in 2020/21 (compared to 559 in 2019/20), valued at £194.83 per point.

QOF 2020-21 COVID-19 adjustments

Practices should continue to prioritise care that is clinically necessary, relevant and possible. It should be delivered primarily by phone or virtually, or by face to face consultation (with appropriate PPE) where required.

Income-protected indicators (310 pts) – Other than areas outlined below, indicators will be subject to income protection. For these indicators, practices will be credited with points based on historical achievement (2018/19) but should nonetheless make efforts to deliver against these indicators as clinically appropriate. Practices will need to decide their approach to patient prioritisation and service delivery with their CCG during Oct-Nov 2020.

Quality improvement (74 pts) – These indicators have been simplified to focus upon a set of national actions in the agreed topic areas of learning disability and early cancer diagnosis. This in order to support and contribute to the delivery of these services, rather than wider QI activities. It will enable practices to learn from the experience of others within their PCN. Peer network support for delivery and sharing of best practice will need to continue to be provided by the PCN.

Immunisation and screening (58 pts) – The points allocated to flu vaccination and cervical screening are doubled in 2020/21. This is to highlight the priority placed on the delivery of these services and the renewed focus upon flu vaccination as part of NHS England’s COVID-19 plans.
It has been agreed that the points for these two domains will be weighted differently to the usual QOF processes, whilst the thresholds remain the same. Practices will accrue a higher number of points at the lower achievement threshold, with the remaining points being achieved in a linear manner between the upper and lower threshold.

Disease registers (81 pts) – Points associated with maintaining accurate disease registers in QOF will be conditional on the ongoing maintenance of registers and associated disease prevalence.

Prescribing named medications (44 pts) – Eight indicators optimising pharmacological management of patients with specific conditions and the prescribing of specified medications will remain conditional upon.


At the beginning of the year, NHSE published the Update to the GP Contract 20/21-23/24 as follows.  

In summary

There are also a number of contractual requirements for 2020/21 – These are notably but not limited to

NHSE have also published a document on Implementing the 2020/21 GP Contract for Personal Medical Services(PMS) and Alternative Provider Medical Services(APMS) contracts. 

The LMC held a number of roadshows, to present this contract update, one of which was presented by Mark Sandford-Wood from the GPC. Mark's powerpoint presentation from the roadshow can be viewed via this link


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. The overarching aim of the scheme is to grow the number of partners – and individuals with equivalent status – working in primary care, stabilising the partnership model and helping to increase clinicians’ participation levels so that primary medical care and the patients it serves have access to the workforce they need.

The scheme gives eligible participants a sum of up to £20,000 plus a contribution towards on-costs of up to £4,000 (for a full time participant) available to support establishment as a partner, as well as up to £3,000 in a training fund to develop non-clinical partnership skills. In order to participate in the scheme, applicants will be required to ensure that they submit an application form and supplementary evidence to NHSEI and meet the eligibility criteria.

To be eligible to participate in the scheme, the applicant must:

Full information is available here:

New to Partnership Guidance




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Updated on Monday, 7 June 2021 4216 views