NHS England unveiled a £30m enhanced service for long COVID as part of an update to the 2021/22 GP contract alongside a £20m weight management enhanced service, and additional PCN funding.
Practices will receive £0.371 per registered patient on signing up to the enhanced service and £0.124 per registered patient on completion on 31 March 2022 - equating to a total of around 50p per patient.
However, some GPs have argued that the current funding package is inadequate, and does not go far enough to reward practices for taking on the extra work - barely allowing them to break even.
Long COVID care
North Staffordshire LMC secretary Dr Chandra Kanneganti said the rate should be quadrupled to £2 to help practices pay for educational updates for all clinical staff and rehab clinics at PCN level.
South London GP Professor Azeem Majeed, head of the department of primary care and public health at Imperial College London, agreed that more funding was needed - warning on social media that he had 'yet to work out' what practices could offer for 50p per patient.
Findings from the Office for National Statistics (ONS) show that almost 1m people in the UK were experiencing self-reported long COVID as of 6 June - and other studies have suggested as many as 400 patients per average practice could be affected. Of those reporting long COVID symptoms in the ONS data, two fifths had experienced symptoms for over a year.
Under the enhanced service, practices will be required to ensure staff are trained on how to identify, assess and manage long COVID, develop support for self management, understand local clinical pathways and can code patient data correctly.
GP funding
Stoke-on-Trent GP Dr Kanneganti said his PCN would sign up to the enhanced service due to demand from patients in the area, but warned that GPs would not necessarily benefit from signing up unless funding was increased.
He said: ‘My PCN is definitely signing up, but we are not signing up for financial gain, it’s actually financially neutral - and possibly puts general practice and PCNs at a bit of a loss.
‘We are expecting that we will have to take histories of the long COVID patients, find out what is happening with them, explore their tiredness, do blood tests and investigations and run echocardiograms, so there is loads of effort actually.
‘I think we should receive a minimum of £2 per weighted list size, [which could be used by PCNs for] educational updates for all clinical staff, as well as multi-disciplinary clinics and rehab clinics at PCN level. But we will start the process because this is a priority for our patients and we’ve started to see more patients [with long COVID].’
Practice workload
Professor Majeed said on Twitter: ‘The new long COVID enhanced service will pay general practices in England under 50p per registered patient. In my 11,000-patient practice, this will amount to around £5,500 per year. I've yet to work out what we could offer with this amount of funding.’
Speaking to GPonline earlier this month, BMA GP committee chair Dr Richard Vautrey said 'growing numbers' of people with long COVID were consulting with general practice. He said the enhanced service was 'a recognition' of these pressures - and pointed out that the condition was creating additional workload for practices often among patients who were previously fit and well and not likely to consult often with their GP.
Despite concerns over the funding attached to the service, some GPs have welcomed the extra support. Northumberland LMC medical secretary Dr Jane Lothian told GPonline: ‘We've got to adjust to what diseases are out there.
‘You don't have to sign up to it, but it's work that we're going to be doing anyway… It's paying GPs a little bit to make sure that their staff are appropriately educated in the matter, and then making the referral.’
The BMA has previously said that the long COVID service provides ‘much-needed additional funding to support practices’, but warned the funding attributed to this work would have to be monitored.
The BMA said when the service was unveiled: ‘This programme must be kept under review, however, with more resources provided to keep up with demand as necessary, while ensuring additional, specialist support for patients with long COVID is available beyond general practice.’
