Update to GP Contract 22/23

NHSE GP Contract page contains a suite of their published guidance. There are a large number of documents covering both contract financials, the PCN DES and QoF. 

Following published guidance for the GP Contract this year, we have put together a summary overview with associated finances.  PLEASE NOTE - There has been a further update from NHSE 26th Sept 2022 and this document should also be read in conjunction with the summary above.

On 1 October 2022, the following changes to the GMS and PMS Contract Regulations and APMS Directions came into force:

• changes regarding premises requirements where services are provided remotely
• expansion of the provisions regarding the disclosure of information about NHS earnings  and confirmation of the disclosure date for self-declaration submissions
• removal of the requirement that 25% of appointments are available for online booking, replaced with a requirement that all directly bookable appointments are able to be booked online, as well as in person or via the telephone.
• the ability for patients to register digitally is now supported.

We are now in year four of a previously agreed 5 Year Deal for General Practice. Whilst BMA GPC had been meeting regularly with NHSEI since January to negotiate changes to the contract, NHSE/I issued a letter on the 1st March 2022 that identifies the contract changes for 22/23.

We have produced a initial summary of these changes.

The BMA have released the following financial information, however, we still await this detail confirmation from NHSE/I.

• Global sum increase of 3%, this takes the cost per weighted patient from £96.78 to £99.70 
• The funding provides for 2.1% pay uplift for staff costs

We recognise this is really disappointing and may cause issues with the retention of staff in light of the cost of living being at approximately 5% along with the introduction of the health & social care levy of 1.25% from April. GPC England had sought additional funding given the economic changes (due in large to the impact of the pandemic) but NHSE/I has refused this. The pay uplift identifies the percentage of what practices have available to use and will need to consider the oncost calculation with this.

• OOH Adjustment remains at 4.75% increasing the value from £4.59 to £4.73
• QOF point value increase of 3.2%, this takes it from £201.16 to £207.56

There have been no changes to QOF from April, however, due to the changes in the average number of patients per practice the value of a QOF point has increased

• Investment & Impact Fund (IIF) will continue at £200 per point

Non Financial Changes

• Booking online appointments – removal of 25% minimum, to be replaced with all directly bookable appointments that do not require triage; this is a new contractual requirement which goes beyond the five-year framework. THE BMA advise this change will allow practices to determine what is most appropriate to make available for online booking; an example of this is flu vaccination or COVID vaccination appointments.
• Removed the requirement to print & send copies of deceased patient electronic records to PCSE & therefore manage access requests to health records of deceased patients
• Minor changes to routine vaccination schedule (HPV, MMR & MenACWY freshers programme) - See our Vacc & Imms webpage.
• Online patient registration – removal of wet signatures and the need for hard copies. Many practices and regions already offer this. NHSEI intends to introduce a new format and will be working on the design principles and is seeking to replace what is already in widespread use.
• Funding to continue for future year (£20m Global Sum) workload associated with SAR.

Directly bookable appointments – guidance for practices

NHSE have issued guidance for practices on directly bookable appointments that are now a contractual requirement. The previous contractual requirement stated that “all practices will ensure at least 25% of appointments are available for online booking”. This requirement – that applied to the entirety of the practice’s appointments – has been replaced by a requirement that practices instead make all of their “directly bookable” appointments available online, as well as by phone or in-person.

It is worth noting that under the amended legislation, practices are able to decide which of their appointments should be made available for direct booking having had due regard to this guidance.

Weight Management

NHSE advise the 22/23 specification includes references to helpful materials, such as the Healthy Weight Coach training programme

We understand that 22/23 largely remains the same as 21/22 although it will be made clearer that:

• practices should not automatically refer all patients on their obesity register
• referrals should be made with the explicit agreement of the individual patient.

NHSE have also produced a GP Toolkit for the NHS Digital Weight Management Programme.

Friends and Family Test (FFT)

The requirement to submit the FFT was suspended across the NHS in March 2020 to free up resources to support practices during the pandemic. The FFT has now restarted across the NHS and the temporary suspension will come to an end in March 2022. The requirement for practices to report to commissioners regarding FFT returns will be reintroduced into the GP contract from 1 April 2022.

We are aware that it will take practices time to get fully up to speed submitting their FFT returns and with this in mind, commissioners should not be expecting FFT data to be submitted until Q2 in 22/23 onwards.

Other Resource Links & Contract Documents 22/23

• NHSE - GP Contract 22/23 Documents
• NHSE  - Ready Reckoner for both Contract and PCN DES
• FLU 22/23
• The BMA - GP Contract changes 22/23
• NHS Digital - QoF Business Rules - This webpage also includes details on business rules for  indicators no longer in QOF.
• NHS Digital - Enhanced Services (ES), Vaccinations and Immunisations (V&I) and Core Contract (CC) components business rules
• NHS Digital - General Practice Pay Transparency: Guidance
• NHSE - New to Partnership Scheme