PCNs in London have been asked to submit plans to increase ‘activity’ by 10% in order to access a £4m funding pot from their ICB.
North West London ICB asked PCNs to submit plans to improve access – as an alternative to their now-scrapped same-day hub model – in order to ‘release burden on other parts of the system’, including emergency care and 111.
It confirmed this week that so far 12 out of 44 applications for funding from PCNs have received final approval, with a deadline to use the money by the end of March.
This 10% activity boost requirement for 2024/25 funding follows the ICB’s previous proposal, to deliver a ‘single point of triage’ for same-day, low complexity demand.
After shelving the proposal in March last year, the ICB committed to finding a way to direct the £6.6m that was intended for the same-day hubs back into general practice.
PCNs were told to conduct an extensive patient engagement exercise in order to access £1.3m of funding, or 50p per weighted patient, and the ICB recently revealed that over 100,000 NWL residents responded.
Our sister title Pulse has now seen documents which reveal the requirements PCNs must meet in order to access the remaining £2 per weighted head of population – a total of £4.1m – before the end of this financial year.
A bid template document said: ‘Funding will be allocated on an expectation that local transformation will allow a 10% uplift in activity which is likely to release burden on other parts of the system, this includes enhanced services delivered in primary care, urgent and emergency care and redirections via 111.’
The ICB told GPs that this ‘minimum’ 10% activity boost should be an improvement to ‘productivity’ by ‘increasing and improving patient contacts without necessarily increasing appointments’.
This ‘return on investment’ could be achieved by ‘improving operational processes’ or ‘changing skills mix’, and GP practices will be required to measure ‘baseline activity’ in order to prove to the ICB that an uplift is being achieved.
According to the ICB, these plans will also help practices ‘meet the access specification’ in the next financial year, which will become part of the enhanced services ‘single offer’ again.
ICB leaders confirmed to patients last week that the 2025/26 specification is still being written, and it will go to the public board meeting in May. But they said the new ‘single offer’ will not include implementation of same-day hubs, as they had proposed last year.
In documents concerning the 2024/25 funding, the local commissioner stressed that all money must be spent by March 2025.
‘Funding will be paid in-year, although the ICB will reserve the right to claim funding back if PCNs fail to deliver agreed plans,’ a document on frequently-asked questions said.
The ICB also confirmed that despite the delays, it will allocate ‘full-year funding’ for PCNs that have ‘demonstrated […] that delivery of activity has been ongoing since April 2024 and is continuing’.
NWL commissioners also said they had ‘held back’ some funds on the basis that ‘not all PCNs will be in a position to submit expressions of interest at this stage’.
Out of the total £6.6m which ICB CEO Rob Hurd promised was ‘ringfenced’ for general practice and ‘will not be used for other services, there is £1.2m remaining, after accounting for the £1.3m patient engagement exercise, and £4.1m for improving access plans.
The ICB said they are ‘still working’ out how any remaining funding should be used if the total funding pot ‘is not allocated to successful bids’ from PCNs.
It confirmed that so far only one PCN has chosen not to submit, while 44 PCNs have applied for the funding, of which:
- 12 have been given final approval and will now get a contract and the funding;
- 6 have received ‘initial approval’, subject to further governance approval;
- 23 are being actively supported to ‘improve’ their bids and ensure they meet the requirements;
- 2 have been rejected, as they ‘do not meet the criteria at this point’;
- 1 has withdrawn.
A spokesperson for NWL ICB said: ‘NHS North West London ran a resident and staff engagement programme that sought to better understand what people felt was working well and not so well regarding access to local general practice.
‘Following that, our PCNs have been asked to submit bids for up to £2 per weighted patient, with a view to starting the process for improving access.
‘The bids were expected to be based upon the initial learning from the engagement. While the closing date for new submissions was 10 January, we have continued to work with PCNs who have submitted proposals to provide feedback and help shape them, with a view to wanting to support as many proposals as possible.’
They also said it is ‘essential that any bids meet the essential criteria to improve access’.
The ICB did not clarify how the remaining money will be used if there are insufficient ‘successful’ bids from PCNs.
‘We are still working within the ICB to determine how any remaining funding should be used if all of the money allocated to this work is not allocated to successful bids,’ it said.
A version of this story was first published on our sister title Pulse.
