In a letter to practices on 7 December, NHS England confirmed further detail of temporary changes to the GP contract intended to free up time for practices to deliver COVID-19 vaccinations.
The update comes just days after officials published an outline of plans for a partial suspension of QOF and other elements of practice workload such as enhanced services.
The letter confirms that 'the four vaccination and immunisation indicators, the two cervical screening indicators, the register indicators and the eight prescribing indicators will continue to operate on the basis of practice performance in 2021/22'.
However, the value of prescribing indicators in this year's framework will be topped up by around £9,250 per average practice. This increase will be achieved by reallocating funding for 46 indicators added to the QOF for the first time this year - on cancer, mental health and hyperglycaemia - for which there is 'no historic performance to use as the basis for income protection'.
Meanwhile, investment and impact fund (IIF) cash worth £112.1m will be 'repurposed' to support PCNs and practices delivering the COVID-19 booster campaign and to ease workforce pressure.
PCN indicators for flu immunisation and appointment categorisation will continue to be paid on performance in the current financial year, but all remaining indicators will be suspended.
A total of £62.4m will be 'allocated to PCNs via a PCN support payment, to be paid on a weighted patient basis, subject to a simple confirmation from the PCN that it will be reinvested into services or workforce'.
The remaining £49.7m will be allocated 'to a new binary IIF indicator, paid on the basis of all practices within a PCN being signed up to phase 3 of the COVID-19 vaccination enhanced service as at 31 December 2021, remaining signed up until 31 March 2022, and actively delivering the programme'.
Practices have only until 10 December 2021 to opt in and must be ready to 'go live' in early January. The letter confirms that in 'exceptional circumstances' PCNs may be able to receive the participation payment despite a practice not delivering COVID-19 vaccination if if this has been agreed with commissioners 'as a result of wider access, performance or patient safety issues'.
The letter says NHS England 'appreciates' the work practices will have carried out to date towards new QOF indicators for which income has been reallocated.
It confirms that the remaining QOF indicators for the current financial year will be 'income protected using a methodology very similar to the one applied in 2020/21', with achievement payments based on 2018/19 performance. Targets for diabetes and hypertension added in 2019/20 will be paid based on performance in that financial year.
NHS England has also confirmed wider measures including income protection for the minor surgery DES, deferral of 'routine health checks on request for those over 75 who have not had a consultation in the last 12 months, and for new patients', and changes to the dispensary services quality scheme.
The letter says: 'We recognise that balancing your resources this winter between the urgent needs of your patients, the management of long-term conditions, and the vital task of vaccination and public health is a daily challenge. The measures in this letter seek to support your professional clinical judgment in balancing these considerations.'