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So, who thought ‘income guarantee’ meant what it said? By Paula the PM

by in Business, GP Practice Management, Work management, Workload

A PM colleague who seems to be well ahead of the game forwarded this letter to me: https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0569-Second-phase-of-General-Practice-response-to-COVID-19–update-to-GP-contracts-and-income-protection-a.pdf

This innocuous looking letter has somehow sneaked into the system although I’m sure I haven’t seen it before. As always, it’s dated after some of the changes it mentions so we’re already behind before we’ve even started. It’s a lengthy 11 pager and as we’re having a ‘virtual’ partners meeting this afternoon, I’ve decided to try to condense it so there’s a chance some of the information will sink in.

So, what were the notable mentions?

If any of your GPs’ revalidation was due between 17 March 2020 and 16 March 2021, their revalidation date has been moved back one year.

GP staff who are shielding because they are at highest risk or who are not performing face to face activity after risk assessment should continue to be supported. The income protection arrangements for general practice and the home working solutions available should help with this.

Further details will shortly be available about the COVID-19 support fund for general practice and legitimate additional expenses as a result of the pandemic.

As a result of the income protection funding, practices cannot make use of the Coronavirus Job Retention Scheme.

None of this is news, but there was further information about funding in the following pages.


  • Income protection is offered until 20 June 2020 for the following:
  • Core practice contract
  • Global sum which will continue to be paid at the agreed rates for the whole of 2020/2
  • QOF – further details of the arrangements for QOF in 2020/21 will be available soon
  • Dispensary Services Quality Scheme (DSQS): Local commissioners must continue to make the same monthly payments for DSQS from 1 April 2020 until 31 July 2020. The DSQS will be re-introduced from 1 August 2020
  • For most of the Directed Enhanced Services and the Local Enhanced Services, income is protected until the end of Q1 20/21 (30 June 2020). Beyond that, there are some serious achievements needed.

QOF 20/21

  • Expansion of the flu programme
  • Focus on cancer and learning disabilities
  • Maintain disease registers and deliver cervical screening figures close to normal
  • Payment for other indicators maintained at prior levels on the basis that care for those most likely to be affected by COVID-19 is the priority. Focus on those with uncontrolled LTC parameters and who miss review appointments
  • QOF to be re-introduced fully from April 2021 unless there is a national agreement otherwise

From June

  • PCSE will resume list reconciliation and data quality checks

1 July

  • Practices should re-introduce the following routine appointments if they were stepped down:
  • New patient reviews (including alcohol dependency)
  • Routine medication reviews
  • Over-75 health checks
  • Clinical reviews of frailty
  • Shingles vaccination to recommence for those who are eligible. In addition, for those who have turned 80 since 1 February 2020, vaccination can be offered on an opportunistic basis between now and 31 December 2020. This will be paid at the same rate as other shingles vaccinations
  • Resume PPG group activities with remote management being actively encouraged
  • Dispensing practices only – resume dispensing list cleansing activities

1 August (Dispensing practices only)

  • Dispensary Services Quality Scheme to be re-introduced from 1 August 2020. Those practices wishing to take part must notify their commissioner

Until 30 September 2020

  • Friends and Family Test returns, reporting to commissioners is suspended
  • In certain circumstances, the temporary suspension of the need for individual patient consent for electronic repeat dispensing.
  • We need to continue to provide the minimum number of slots available for direct booking by 111, i.e. 1 slot per 500 patients

So, what were my overall conclusions after reading the letter? Well, as many of the issues raised are going to require face to face input, I’m not sure how easy to achieve any of the second phase is going to be. There don’t appear to have been any corresponding changes to infection control, so the time we’re going to need to allow for appointments will be lengthy, not to mention the steam train that is the flu vaccination thundering down the track. One improvement seems to be the impending arrival of COVID-19 swab tests into the patient record. Assuming the results are timely, we will at least know whether patients have had a test recently, just in case they’re not entirely honest with us.

There have been some changes to the SOP and at least the updates are highlighted in yellow, some of which will need to be filtered into the way we work.

I’m off to plan for an expansion to our flu clinics, without any real guidance on who we might need to include or where the additional vaccine is coming from. How to deal with a mass of elderly and vulnerable patients is causing me regular cold sweats. I’ve also got the unenviable job of setting our nurse manager to work on identifying ways we can safely bring more patients into surgery while still cleaning like Cinderella. No-one ever said practice management would be easy and recently that’s been truer than ever.

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Paula the PM

Paula the PM

Local Practice Manager

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