• Suspended GP contract requirements restarted as GPs told to address needs of covid and non-covid patients
  • GPs told to “gear up” for a larger flu vaccination programme in the coming months
  • Primary care networks encouraged again to use funding to hire new clinical staff or see the money “lost to primary care”

NHS England has told GPs to restart some services that were suspended during the initial response to the coronavirus pandemic.

Primary care directors Nikki Kanani and Ed Waller wrote to GPs telling them the best way to address the twin demands of covid and non-covid patients will be “sustaining many of the transformations in ways of working adopted during the height of the pandemic”.

This means total triage, the division of the primary care estate into hot hubs for treating covid-positive patients “where these have been established and make sense in a longer-term offer” and the “rapid scaling of technology-enabled service delivery options”.

GPs were told “digital consultation should be offered as standard unless there are good clinical reasons otherwise”, though practices must “now deliver face-to-face care, where clinically appropriate”.

“There is an urgent need to prioritise key aspects of primary care not directly related to covid-19 itself” because the virus “has had a disproportionate impact on certain sections of the population,” the letter added, including people with long term health conditions “mirroring and reinforcing existing health inequalities”, the letter said.

QOF returns

NHS England will use changes to the quality and outcome framework requirements, which provides financial incentives to GPs for specific activities, to provide focussed incentives to GPs to address pressing non-covid challenges.

For example, GPs will also be asked to focus on “early cancer diagnosis and care of people with learning disability”, with the details still being discussed with the BMA’s general practice committee. Health checks for patients over 75, health reviews for new patients, and clinical reviews of frailty and routine medication reviews, will also return. The obligation to report results of the friend and family test to commissioners is still suspended, however.

Practices will also be asked to “gear up for a major expansion of the winter flu programme”, although the precise details of this are under discussion with the British Medical Association, the letter added.

Workforce requirements

The letter also reiterated NHS England’s call for primary care networks to hire in new clinical staff made available under specific funding streams in the PCN contract.

It also sought to address concerns about the longevity of the new PCN clinical roles beyond the five-year PCN contract framework that runs up to 2023-24.

It said NHSE is “committed to the continued funding of these roles” and said if a PCN were to disband with practices withdrawing from the PCN contact in the future, commissioners would seek to support the transfer of relevant staff from the outgoing practices to the new provider of network services”.

Topics