In a letter to commissioners last week, NHS England deputy director of primary care strategy Robert Kettell confirmed PCNs that underspent on their 'additional roles reimbursement scheme' funding could lose their right to the extra capital under new guidance.
Surplus money is likely to be offered to other PCNs within the same CCG area if they are making ‘swift progress’ with their recruitment efforts. The letter said NHS England 'strongly encourages CCGs to put in place local schemes to share that unused financial entitlement across the other PCNs in the area'.
These fast-moving PCNs could then bring forward recruitment plans from the subsequent year, the primary care strategy lead said.
The letter says: ‘For 2019/20, in the unlikely event that a CCG forecasts an underspend on its additional roles reimbursement scheme funding, NHS England strongly encourages CCGs to put in place local schemes to share that unused financial entitlement across the other PCNs in the area to enable them to carry out further recruitment.
‘This would enable those PCNs which have made swift progress in recruiting to the additional roles set out in the network contract DES to bring forward further recruitment plans from the subsequent year.’
The letter makes clear that although funding could be stripped from PCNs unable to spend it immediately and moved elsewhere, the money could not be used outside the terms of the DES.
Under the DES contract, funding is made available to PCNs to recruit up to an additional 20,000 full-time equivalent post across five specific roles, including physios, social prescribers, pharmacists and others by 2023/24.
The intention of the scheme is to grow additional capacity through new roles, and by doing so, help to solve the workforce shortage in general practice - not to fill existing vacancies.
However, GP partners recently expressed doubt over PCNs’ ability to deliver on this 20,000 target, with just 14% saying that the networks would help to reduce capacity and skill deficiency within practice.
Speaking to GPonline, BMA GP committee chair Dr Richard Vautrey said it was important for general practice to retain the money delivered through the network contract DES.
‘We want to see the funding made available for PCN workforce expansion spent in general practice and not lost to other NHS budgets,' he said. ‘The guidance to PCNs outlines how this can be done, even towards the end of the financial year, by taking on extra staff in advance of the next financial year.
Primary care networks
‘However if money is not used then other local PCNs may be able to utilise it rather than losing it altogether’.
When asked whether the decision to re-allocate funding to better performing PCNs could create inequalities between networks operating in the same areas, Dr Vautrey said it was up to neighbouring networks to pull together to overcome problems.
‘I would hope that PCNs in an area are working together to recruit staff to reduce the risk of some recruiting staff when others have more problems doing so,’ he said.
NHS England has also confirmed that networks hitting targets would be given financial incentives for their hard work.
PCNs will be measured against the DES service specifications, which set minimum requirements for networks in their first year of existence. The letter said that PCNs ‘which go further and faster' to deliver on these targets would receive additional funding, but stopped short of confirming how much this would be.
It said the Impact and Investment Fund (IIF) would provide an incentive for PCNs to reduce demand on NHS services, including overprescribing and ‘inappropriate A&E attendances.
The IIF is expected to commence in April 2020, with NHSE currently developing proposals for the first year of operation.