The funding and requirements of the extended hours access enhanced service will become part of the network contract DES when it begins in July and money for this work will be paid to each network’s ‘nominated provider’, rather than directly to practices.
A practice with an average list size of 8,533 patient earns just over £16,000 from the extended hours DES, raising concerns that some practices could lose out if this money was channelled through networks.
However, GPC chair Dr Richard Vautrey said he expected networks to hand the money back to practices to enable them to carry on doing the same work to meet extended hours obligations that will now fall under the new network DES.
Network contract DES
The network contract DES, agreed as part of the new five-year GP contract in England, provides a package of funding to support the creation and staffing of primary care networks, along with a template network agreement to underpin how practices work together.
The DES takes effect on 1 July 2019 and last week it was revealed that practices will be paid £1.76 per weighted patient for signing up.
Further funding for the DES - such as staff and administration costs - will be paid to a single ‘nominated provider’ within the network, with current funding for the extended hours access DES also moving to networks.
Dr Vautrey said: ‘We would expect the funding to be returned to practices that do the work related to extended hours. The network is the constituent practices and those that do work will be paid for it using the resources held by the primary care network.
‘In the future primary care networks will also have control over the additional £6 per patient for extended access funding and those that deliver this work will be paid using this funding.’
Full details of the network contract DES, including funding arrangements, are due to be published shortly.
Under the new contract, from 2021/22 funding from the extended hours access DES will be combined with the £6 a head that CCGs currently receive for enhanced access arrangements. Networks will receive this money in exchange for implementing ‘more joined-up access requirements’, which will be defined following an access review.
The review is due to take place this year and is aiming to learn from existing extended access schemes, examine how primary care networks can best work with urgent care, for example with urgent treatment centres and GP streaming services in A&E, reduce variation in long waits for appointments and look at how digital advances can help improve access.
Some networks could begin implementing the new system in 2020, ahead of it being rolled out across England in April 2021.