Primary care to lose millions in funding unless PCNs hit recruitment targets in pandemic

Hundreds of millions of pounds could be lost to primary care if primary care networks (PCNs) fail to recruit 'additional roles' staff in 2020/21 despite the ongoing pandemic, NHS England has warned.

Funding at risk (Photo: Viktoria Rodriguez/EyeEm/Getty Images)
Funding at risk (Photo: Viktoria Rodriguez/EyeEm/Getty Images)

In a letter to GPs sent on 9 July, NHS England urged practices to take immediate steps to expand workforce capacity by using additional roles reimbursement scheme (ARRS) monies available in 2020/21.

Primary care bosses also confirmed that PCN development funding would be provided to networks to enable them to support staff induction and retention, and announced that the Investment and Impact Fund (IIF) would restart from 1 October 2020.

NHS England also reiterated its commitment to expanding the GP workforce as it prepares to publish guidance on initiatives to combat GP recruitment and retention.

Primary care workforce

A letter from NHS England primary care director Dr Nikki Kanani and primary care strategy and contracts director Ed Waller identified workforce expansion as ‘a top priority for PCNs’ this year.

They explained that this would be crucial in efforts to ‘relieve workforce pressures’ and ensure primary care’s future sustainability.

‘Over 98% of practices are now signed up as members of a PCN, with access to up to £430m of investment that will be made available in primary care where PCNs employ new staff across 10 workforce roles (with at least a further two roles to follow in 2021/22).

‘The DES reimburses 100% of actual salary costs plus employer on-costs (up to the maximum levels set out in the scheme), thereby significantly reducing the financial investment being asked of practices and PCNs from their core funding. We urge all PCNs to take immediate steps to plan to expand capacity now, by using this funding rather than it being lost to primary care in 2020/21,' they said.

Supporting new staff

NHS England officials insisted that support for staff recruitment and deployment was available from CCGs and community service partners.

GP leaders have said staff such as social prescribers will be crucial to help practices manage workload in the second phase of the pandemic. However, a recent survey by the National Association of Link Workers (NASW) found that 29% of social prescribers were considering leaving their role within the next year due to a lack of clinical supervision and professional support.

The letter says NHS England remains ‘committed to the continued funding’ of additional roles amid concerns around employment liabilities. But it added that where all practices in a PCN withdraw from the network DES, additional roles staff would be reassigned to 'the new provider of network services'.

The IIF will start up again from the beginning of October after being deferred in April following the outbreak of the pandemic. The first six months of IIF monies (£16.25m) have been recycled into the network DES as a PCN support payment, worth £0.27 per weighted patient.

Primary care bosses also revealed work to increase GP numbers. The letter said: 'We are asking systems, working with training hubs, to implement GP recruitment and retention initiatives in their area. Guidance will be published on each of the initiatives through the summer.'

Last week the government rolled out its £20,000 golden hello scheme to stem the loss of GPs in partnership roles in England over recent years. General practice has lost more than 3,600 full-time equivalent GP partners over the past four years.

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