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2023/24 Network Contract DES and associated guidance

The 2023/24 Network Contract DES and associated guidance, was published on 30 March 2023 and contains a number of significant developments to the directed enhanced service (DES) that integrated care boards (ICBs) and primary care networks (PCNs) should be aware of. Many of the changes to the documentation relate to the move from CCGs to ICBs and the fact that some of the service specifications that were in development or transition in 2022/23 are now business as usual such as Enhanced Access and Cardiovascular Disease (CVD) Prevention and Diagnosis. Additional / updated guidance to support delivery of the DES service specifications has also been published.

There has also been confirmation of the payments available to PCNs:

Payment details and allocationAmount
Core PCN funding£1.50 per year per registered patient
Clinical director contribution£0.729 per year per registered patient
Enhanced Access£7.578 per year multiplied by the PCN’s adjusted population
Care home premium£120 per year per bed
Leadership and management payment£0.684 per year multiplied by the PCN’s adjusted population
PCN Capacity and Access Support payment£2.765 per year multiplied by the PCN’s adjusted population

Additional Roles Reimbursement Scheme (ARRS) funding continues to cover actual salary plus employer on-costs (National Insurance and pension) to the maximum per whole time equivalent amounts as outlined in Network Contract DES Specification and will therefore be dependent on the roles utilised by each PCN. There have been a number of changes to the ARRS including:

  • Addition of advanced clinical nurse practitioners
  • Increasing the cap on advanced practitioners to three per PCN
  • Removal of caps on mental health practitioners
  • Reference to the ability for PCNs to pool funding
  • Where there are restrictions on the number of full time equivalent (FTE) per PCN, they can split this FTE between multiple members of staff and can claim reimbursement for up to a maximum of one FTE.

2023/24 sees a reduction in the number of investment and impact fund (IIF) indicators from 36 to five with the associated funding (£246m) being used to support the introduction of a new Capacity and Access Payment which is designed to focus PCNs on improving access for patients.  A separate document Capacity and Access Payment 2023/24 Guidance provides detail on how this will operate.  The funding will be made up of two parts. 

  • National Capacity and Access Support payment: 70% of funding (£172.2m) will be (unconditionally) paid to PCNs, based on their adjusted population, in 12 equal payments over the 2023/24 financial year. For an average PCN this equates to approximately £11.5k per month.
  • Local Capacity and Access Improvement payment: 30% of the funding (£73.8m) will be paid to PCNs based on their delivery of an agreed access improvement plan. Full delivery against the plan for an average PCN would be worth approximately £60k. The plan must cover three, equally weighted areas:
  • patient experience of contact;
  • ease of access and demand management; and
  • accuracy of recording in appointment books.

From April, PCNs and commissioners need to:

  • Complete an assessment of the current position based on criteria contained within the document
  • Develop and agree an access improvement plan

PCC offers workshops providing detail on the Network Contract DES. For more information visit www.pcc-cic.org.uk or contact enquiries@pcc-cic.org.uk.

Last Updated on 4 April 2023