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ICBs must use system funding to tackle inequalities, deprivation and recruitment challenges

ICBs must use system funding to tackle inequalities, deprivation and recruitment challenges
By Jess Hacker
29 September 2022

Integrated care boards (ICBs) should prioritise system spending in areas which are deprived, have the highest health inequalities and the ‘most serious’ recruitment challenges, NHS England has said.

It also called for the existing system development fund (SDF), which is targeted at primary care transformation and workforce projects, to be used to implement its new framework for supporting general practice and primary care networks.

The update to the aims of the SDF are part of a major plan to expand general practice capacity and improve access during a ‘period of sustained significant pressure’ this winter.


NHS England has published an analysis of SDF programmes and funding in 2022/23.

The NHSE Primary Care Group provides SDF to health systems each year under the Long Term Plan, however the formation of ICBs – which gained statutory footing in July – has provided ‘fresh impetus’ to ensure primary care is supported.

It said: ‘We want to encourage systems to use the Primary Care SDF to build an expanded and resilient workforce supported by an underpinning coordinated approach to Primary Care improvement and development.’

The SDF is grouped into two overall themes: transformation and workforce.

The GP Transformational Support Fund – which combines two previous programmes, Digital First and PCN Development – has a combined fund total of £78m for 2022/23.

Meanwhile, ICBs have access to £634m for 2022/23 for the Additional Roles Reimbursement Scheme (ARRS) included in their baseline, with £393m held centrally and released when needed.

And at least £43 million is available nationally for 2022/23 for general practice fellowships for GPs and nurses who are new to practice.

The SDF update can be found here.

The framework

In a letter sent to GP practices this week, NHS England published a new ICB framework intended to help ICBs ‘rapidly assess’ where to allocate funding for ‘rapid improvement’ across general practice.

Part of the framework – split into two halves – is aimed at building ‘ongoing quality improvement’ within primary care to be supported by ‘ongoing’ SDF and transformation funding.

The other half will see ICS teams scope out where additional funding could be allocated, should it become available.

The framework’s key line of questioning

NHS England said systems should use the SDF to support action on key lines of inquiry, including:

  • How is cloud based telephony being used to improve patient access, and how is good
    practice shared?
  • How does the data on use of 111 services during 8-6.30pm compare when benchmarked to local practices?
  • Does the ICS plan to support further automation of practice functions?
  • Do practices have effective systems in place for care navigation?
  • How could the ICS support PCNs to ensure ARRS roles are working as effectively as
    they could to help meet demand?
  • What are the vacancy levels across clinical/admin teams?

The framework can be found in full, here.

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