Reformed IIF payment format could start from 2022/23

A major overhaul of how PCNs are paid for meeting targets in the Investment and Impact Fund (IIF) could kick in from 2022/23, GPonline understands.

PCN funding reform (Photo: John Lamb/Getty Images)

Last week GPonline reported that health leaders were considering changing the way IIF funding is distributed to networks, delivering part of it upfront in monthly payments instead of all at the end of the financial year - similar to the way QOF payments work.

Senior GPs have backed this idea, highlighting that a mix of upfront and end-of-year payments would allow networks to recruit staff to begin work on the indicators earlier.

NHS England has confirmed that the change will not be implemented in the current financial year, but did not rule out an overhaul in 2022/23.

Investment and Impact Fund

It comes as health leaders confirmed last month that most of the indicators this year will support preparatory work towards the PCN service requirements or the introduction of full performance indicators in 2022/23.

Practices receive the bulk of QOF funding each year upfront via a monthly ‘aspiration’ payment, with the balance paid through an 'achievement' payment after the end of each financial year.

PCNs, however, are currently paid for performance against IIF targets only through 'achievement' payments - the bulk of which come after the end of each financial year. The change would mean that networks receive funding up-front - allowing them to bring in the staff they need earlier.

The IIF will be worth £150m to PCNs for 2021/22 and £225m for 2022/23, meaning IIF work is worth around £120,000 per average PCN in the current financial year and around £180,000 next year. A QOF-style aspiration-achievement split could see more than two-thirds of this paid upfront throughout each financial year.

PCN workforce

Senior clinical advisor to the NHS Confederation Dr Graham Jackson has argued that networks should be paid IIF funding monthly to support work on targets in the framework. He said: ‘This is a really big investment for PCNs. It's not going to be as easy as ticking a few boxes and getting the money - it's essentially a new QOF for PCNs.

'It's a shift in that direction - and PCNs should be thinking about building this into their baseline as an income, the same way that QOF is now baseline income for practices.

‘However, what it needs - and something which we have already had a conversation with NHS England about - is that the IIF needs to be paid aspirationally, like QOF is paid aspirationally, so you get paid every month and then you receive a top-up at the end of the year. This would allow people to start spending the money on workforce to deliver this IIF.’

Last month NHS England announced that PCN service requirements will be gradually phased in over the next 18 months - with just two beginning from October this year. The BMA this week accused the government of being disingenuous over indicators setting out targets for online GP consultations.

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