Declaration of completion for “simpler online requests” in the 2024/25 PCN DES
As part of the 24/25 collective action, GPC England previously advised primary care networks (PCNs) and their practices to defer signing up to the 2024/25 PCN DES (Directed Enhanced Service) CAIP (Capacity and Access Improvement Payment) voluntary incentive component – “simpler online requests”. That required PCN member practices to allow their patients access to e-consultations at least throughout core hours.
We also advised PCNs and practices with outstanding claims for this component of the CAIP incentive, if they wished to accept this requirement, to submit their claim ahead of the 31st March 2025 deadline. As per the 24/25 DES Specification, a PCN “can notify the commissioner at any time prior to 31 March 2025” and following receipt of the CAIP payment form, the commissioner will arrange for payment of the relevant amount for that part of the CAIP, representing the full years’ payment in such a case.
Any PCN Clinical Director that demonstrated compliance with the requirements of this incentive for 24/25 to the ICB by 31st March therefore earned the incentive payment for the PCN. From 1st April 2025, which is a new financial / incentive year, the requirements of this component of the CAIP remain the same in 25/26 as they were in 24/25. This means that PCNs have the remainder of the 25/26 financial year to meet the requirements to receive the full incentive payment.
It would be reasonable for PCNs / practices to now review their e-consult arrangements given it has been accepted nationally, via the 25/26 GP contract agreement, that it is not safe for either patients or staff to invite urgent medical requests via e-consultations. The intended 25/26 contractual change, which will occur by 1st October 2025 at the earliest, will be for ‘non-urgent appointment requests, medication queries and admin requests’, and there is no contractual requirement as to how quickly a practice will need to respond.
However, if they believe they can make it work in a way that does not jeopardise safe patient care or overwhelm staff and damage their wellbeing, this does not stop PCNs and their practices from collectively choosing to explore ways to safely introduce patient access to e-consultations throughout core hours for any request if they wish to. The funding from this component of the CAIP from both 24/25 and 25/26 will help PCNs and practices to adapt to this change.
It is also imperative that ICBs support General Practice organisational development rather than penalise at this time of high patient need. There will be a razor-sharp focus on clinical and workload safeguards relating to e-consultations in national discussions. As we approach 1st October 2025, it will be necessary to determine that full switch on throughout core hours will indeed be safe before it can happen. 24/25 and 25/26 CAIP funding can usefully help PCNs to work with their practices to determine what and how to implement patient and staff clinical and workload safeguards. The intention here is to make it easier for both patients and practices to efficiently manage same day (telephone and walk-up) and non-urgent (e-consultation) care.
It is in nobody’s interest for access to e-consultations to become unmanageable, so we strongly urge ICBs to work with LMCs (local medical committees) – who represent their constituent practices – should there be any local issues around payment and or compliance.
We continue to encourage practices to follow existing GPC England Safe Working Guidance.
Read further information pertaining to the PCN DES for 2024/25 and 2025/26:
PCN financial entitlements
This is a summary of the financial entitlements for PCNs for 2025/26.
| Payment details | Amount |
|---|---|
| Core PCN funding | £2.999 per patient, with £2.266 being multiplied by the PCN registered list size as at 1 January 2025 and £0.733 multiplied by PCN adjusted population as at 1 January 2025 |
| Staff reimbursements | Actual salary plus employer on-costs to the maximum per WTE amounts as outlined in network contract DES specification |
| Extended access | £8.427 multiplied by the PCN’s Adjusted Population at 1 January 2025. |
| Care home premium | £130.253 per bed per year |
| PCN capacity and access support | £3.208 multiplied by the PCN’s Adjusted Population at 1 January 2025 |
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.
For 2025/26 the GP ARRS, and it’s allocated funding, will be rolled into the main ARRS. Practice nurses will also be included as a new addition to the ARRS. For further details and requirements of all ARRS roles, consult the PCN DES specification.
Annual reimbursement rates 2025/26
| Role | Agenda for change band | Maximum reimbursable amount per role (excluding any HCAS) |
|---|---|---|
| Advanced practitioner | 8a | £73,334 |
| Care coordinator | 4 | £36,150 |
| Clinical pharmacist | 7-8a | £66,972 |
| Consultant Nurses Primary Care | 8a | £73,334 |
| Dietitian | 7 | £64,907 |
| Digital and transformation lead | 8a | £73,334 |
| Enhanced Practice Nurses | 7 | £64,907 |
| First contact physiotherapist | 7-8a | £66,972 |
| General Medical Practitioners | - | £105,882 |
| General practice assistant | 4 | £36,150 |
| General practice nurse (new) | 5 | £43,352 |
| General practice nurse (experienced) | 6 | £53,319 |
| Health and wellbeing coach | Up to 5 | £43,352 |
| Healthcare Support Workers | 3 | £32,159 |
| Mental health practitioners* | 5 / 6 / 7 / 8a (depending on the individual registered clinician providing the service) | £18,075– £36,667 |
| Nursing associate | 4 | £36,150 |
| Student Nursing Associates | 3 | £32,159 |
| Occupational therapist | 7 | £64,907 |
| Community paramedic | 7 | £64,907 |
| Pharmacy technician | 5 | £43,352 |
| Podiatrist | 7 | £64,907 |
| Social prescribing link worker | Up to 5 | £43,352 |
| Physician associate | 7 | £64,907 |
| Physician associate (apprentice) | 3 | £43,352 |
*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 Indicators 2025/26
The table below outlines the IIF indicators for 2025/26, the points and funding available for each indicator. Indicators remain unchanged for 2025/26.
| Indicator | Points available | Lower threshold | Upper threshold |
|---|---|---|---|
| HI-03: 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 | 60% | 80% |
| CAN-04: 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% |
IIF Capacity and Access Payments
Capacity and Access Support Payments (£172.2m)
Since October 2022, PCNs have been able to receive a monthly CASP. This is paid to PCNs, proportionally to their adjusted population, in 12 equal payments over the 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 2025/26, the local aspect of the CASP will be split into 2 parts:
- supporting modern general practice access
- risk stratification to support continuity of care
BMA Law offers a variety of flexible and cost-effective services, from network agreements to practice premise contracts.