This is a summary of the financial entitlements for PCNs for 2023/24.
Summary of PCN DES (direct enhanced service) financial entitlements
| Payment details | Amount |
|---|---|
| Core PCN funding | £1.50 per registered patient per year (£0.125 per patient per month) |
| Clinical director contribution | £0.729 per registered patient per year (£0.06 per patient per month) |
| Staff reimbursements | Actual salary plus employer on-costs to the maximum per WTE amounts as outlined in network contract DES specification |
| Extended access | £ 7.578 per weighted patient |
| Care home premium | £120 per bed per year |
| PCN capacity and access support | £2.765 x adjusted population size (To be paid monthly through the 22/23 winter period.) |
| PCN capacity and access incentive payment | £1.185 per registered patient |
| PCN Leadership and Management Payment | £0.68 multiplied by the PCN Adjusted Population (£0.058 multiplied by the PCN Adjusted Population per month) |
In addition to the payments made to the PCN’s nominated payee under the terms of the network contract DES, participating practices will be entitled to the network participation payment (£1.76 per patient).
ARRS (additional roles reimbursement scheme)
Each PCN is allocated an additional roles reimbursement sum for the year. This is based on the PCN’s weighted population share of the total ARRS funding. PCNs are able to claim up to this maximum sum each year.
For PCNs in London, the maximum reimbursement amounts per role within the ARRS will now include inner and outer London weighting on top of maximum current ARRS reimbursement amounts.
Annual reimbursement rates 2022/23
| Role | Agenda for change band | Maximum reimbursable amount per role (excluding any HCAS) |
|---|---|---|
| Advanced practitioner | 8a | 65,002 |
| Care coordinator | 4 | 31,746 |
| Clinical pharmacist | 7-8a | 59,312 |
| Dietitian | 7 | 57,465 |
| Digital and transformation lead | 8a | 65,002 |
| First contact physiotherapist | 7-8a | 59,312 |
| General practice assistant | 4 | 31,746 |
| Health and wellbeing coach | Up to 5 | 38,187 |
| Mental health practitioners* | 5 / 6 / 7 / 8a (depending on the individual registered clinician providing the service) | 15,873 – 32,501 |
| Nursing associate | 4 | 31,746 |
| Nurse training associate | 3 | 28,177 |
| Occupational therapist | 7 | 57,465 |
| Paramedic | 7 | 55,313 |
| Pharmacy technician | 5 | 38,187 |
| Podiatrist | 7 | 57,465 |
| Social prescribing link worker | Up to 5 | 38,187 |
| Physician associate | 7 | |
| Physician associate (apprentice) | 3 | 38,187 |
*The rates are set at 50% of the standard levels, reflecting the 50% PCN contribution to the salary and employer costs for the individual delivering the service.
IIF (investment and impact fund)
The Investment and Impact Fund (IIF) was introduced as part of the Network Contract DES in 2020, with PCNs rewarded for delivering objectives set out in the NHS Long Term Plan and the five-year agreement document.
Total IIF funding will rise to £305 million for 2023/24, as previously agreed. However, there will be a different approach to most IIF funding, with only 5 individual indicators remaining (reduced from 32 in 2022/23). The only target indicators for 23/24 will be on seasonal flu vaccination (including for over 65s, patients aged 18-64 in a clinically at-risk group, and children aged 2-3 years), ethnicity recording within annual Learning Disability Health Checks, level of appointments made within 2 weeks and FIT referrals
The majority of IIF funding for 23/24 will be channelled towards access related payments. This will be split into two parts:
- Capacity and Access Support Payment (CASP): 70% of the non-indicator related IIF funding will go into the Capacity and Access Support Payment, first introduced in October 2022.
- Local Capacity and Access Support Payment (LCASP): 30% of the non-indicator related IIF funding will go into a new Local Capacity and Access Support Payment.
Further details on these payments can be found below.
Monies earned from the Fund must be used for workforce expansion and services in primary care. Each PCN will need to agree with their ICB how they intend to reinvest monies earned. This can take the form of a simple reinvestment commitment.
IIF Indicators 2023/24
The table below outlines the IIF indicators for 2023/24, the points and funding available for each indicator.
| Indicator | Points available | Lower threshold | Upper threshold | Total funding |
|---|---|---|---|---|
| Prevention and tackling health inequalities domain Vaccination & immunisation area | ||||
| VI-02: Percentage of patients aged 18 to 64 years and in a clinical at-risk group who received a seasonal influenza vaccination between 1 September and 31 March | 113 points | 72% | 90% | £25.5m |
| VI-03: Percentage of children aged 2-3 who received a seasonal influenza vaccination between 1 September and 31 March | 20 points | 64% | 82% | £4.5m |
| Health inequalities area | ||||
| HI-01: Percentage of patients on the QOF Learning Disability register aged 14 or over, who received an annual Learning Disability Health Check and have a completed Health Action Plan to a recording of ethnicity | 36 points | 49% | 80% | £8.1m |
| Providing high quality care domain Cancer area | ||||
| CAN-02: Percentage of lower gastrointestinal two week wait (fast track) cancer referrals accompanied by a faecal immunochemical test result, with the result recorded in the twenty-one days leading up to the referral | 22 points | 65% | 80% | £5m |
| Access area | ||||
| ACC-08: Percentage of patients whose time from booking to appointment was two weeks or less | 71 points | 85% | 98% | £16m |
IIF Capacity and Access Payments
Capacity and Access Support Payments (£172.2m)
Since October 2022, PCNs have been able to receive a monthly CASP. For 2023/24 this is to be expanded and paid to PCNs, proportionally to their adjusted population, in 12 equal payments over the 2023/24 financial year. On average, it’s expected that a PCN should receive around £137k over the course of the year, or around £11.4k a month through this payment.
Capacity and Access Improvement Payment (£73.8m)
New for 2023/24, the local aspect of the CASP is to be paid based on the respective ICB’s assessment of a PCNs performance on providing ‘good access’ for their populations, as determined by the process set out below. This payment would be worth around £59k on average for a PCN and would be paid out in a single payment by 31 August of 24/25.
The payment of the Capacity and Access Improvement Payment will be made based on a PCN making improvements in three areas:
- patient experience of contact
- ease of access and demand management
- accuracy of recording in appointment books.
At the start of the 23/24 contract year PCNs will need to work with commissioners to set their ‘baseline’ for these areas by completing a template form, as set out in in NHS England’s guidance ,by the 12th May 2023..
ICBs should then work with PCNs to monitor their improvement against the baseline positions during 2023/24 providing support where necessary.
Based on the PCN’s improvement in these three areas, ICBs will assess the appropriate value of funds to be released, after 31 March 2024, to be paid out before 31 August 2024. The criteria for assessment of local improvement across the three areas is set out in NHS England guidance.