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1st April 2022

PCN DES 2022/23


NHS England and NHS Improvement (NHSEI) has published the revised Network Contract Directed Enhanced Service (DES) which takes effect from 1 April 2022.

The vast majority of the proposals are not new and build on the five-year contractual framework, Investment and Evolution, agreed with the BMA’s General Practice Committee England (GPC England) in January 2019.

The amended DES introduces changes to the following areas, as set out in detail below:

  • The amount available under the 2022/23 Network Contract DES for PCNs to recruit additional staff under the Additional Roles Reimbursement Scheme (ARRS) increases by £280 million to just over £1 billion. PCNs will have flexibility to hire into any of 15 different roles.
  • Where agreed between the PCN and the local Community Mental Health Provider, PCNs may be reimbursed for a further Mental Health Practitioner roles (or a further two for PCNs with a population of over 100k) to support people with complex mental health needs, that can be employed on a 50:50 shared reimbursement model.
  • The PCN Clinical Director funding for 2022/23 has been agreed as £0.736 per head
  • The updated 2022/23 DES combines the two funding streams; extended access and extended hours, to fund a single, combined and nationally consistent access offer with updated requirements, to be delivered by PCNs. This brings together the current £1.44 per head Network Contract DES extended hours funding and the current £6 per head CCG-commissioned extended access services. The funding will be paid to PCNs on the basis of the PCN adjusted population, and PCNs may check their funding via the updated 2022/23 GP contract ready reckoner 
  • The new offer is based on PCNs providing bookable appointments outside core hours within the Enhanced Access period of 6.30pm-8pm weekday evenings and 9am-5pm on Saturdays, utilising the full multi-disciplinary team, and offering a range of general practice services, including ‘routine’ services such as screening, vaccinations and health checks, in line with patient preference and need. PCNs will be able to provide a proportion of Enhanced Access outside of these hours, for example early morning or on a Sunday, where this is in line with patient need locally and it is agreed with the commissioner.
  • PCNs will continue to deliver the current extended hours access arrangements from April 2022 until October 2022, at which point the new enhanced access service will begin. PCNs will need to undertake the preparatory requirements from April 2022, as set out in the updated 2022/23 DES specification.
  •  a limited expansion of the Cardiovascular Disease Prevention and Diagnosis service.
  • requirements for the phased introduction of the Anticipatory Care and Personalised Care services. To note, there have been two amendments from the plans published in August 2021.For Anticipatory Care, PCNs now have until December 2022 to develop their anticipatory care plans, with the ICS led Anticipatory Care service starting in 2023/24. For Personalised Care, PCNs now have until 31 March 2024 to implement digitally enabled personalised care and support planning for care home residents.
  • three new Investment and Impact Fund (IIF) indicators, which are focused on Direct Oral Anticoagulants (DOAC) prescribing and FIT testing for cancer referrals. These changes will help to ensure that a greater number of patients with Atrial Fibrillation receive anticoagulation therapy where clinically appropriate and that more patients with suspected lower gastrointestinal cancer will have their two week wait referral accompanied by a FIT test result.
  • Practices already signed up in 2021/22 will automatically participate in the updated 2022/23 DES. This means that PCNs with no changes to their membership or information do not need to submit any sign-up information to their CCG to continue to participate. PCNs with changes must notify the commissioner by 30 April 2022 to seek approval of those changes.
  • If a practice wishes to sign up to, or opt out of, the DES, it must inform its clinical commissioning group (CCG) by 30 April 2022.The CCG will work with the remaining practices in the PCN to consider the consequences, including whether the PCN remains viable. Similarly, if a practice wishes to opt into the DES, it must inform its CCG by 30 April 2022 in accordance with the process set out in the DES Specification and Guidance.