IIF Funding structure
Introduction
In the following article we seek to simplify and explain the way that IIF is funded.
Before you can understand the payment metrics of IIF, you have to understand the types of indicator as these are measured in different ways and funding allocated accordingly. The IIF is a points-based scheme. For 2024/25, each PCN can earn a maximum of 58 IIF points and the value of a point is £198.00
Types of indicator
Quantitative indicators
Standard
This type of quantitative indicator has a numerator and denominator that has an upper and lower threshold.
If a PCNs performance is at least as good as the upper threshold it earns all of the points available for the indicator.
If a PCNs performance is equal to or worse than the lower threshold it earns zero points.
If the PCNs performance is between the upper and lower thresholds a sliding scale of points will be awarded. To calculate the points per percentage point, take the number of points for the indicator and divide it by the difference between the upper and lower threshold in %.
Funding
For each indicator, a PCN’s achievement payment equals its achievement
points multiplied by the value of an IIF point (£198.00 in 2024/25), multiplied
by a list size adjustment multiplied
by a prevalence adjustment.
Impact of prevalence
Prevalence affects the Quantitative indicators within IIF. Prevalence is calculated for the PCN by usually taking the denominator for the indicator divided by the total number of patients within the PCN. The prevalence adjustment for an indicator is calculated by the PCN prevalence divided by the national prevalence.
The million dollar question is "is it worth chasing prevalence in our PCN?" Indeed the guidance makes reference to this:
As well as making payments more proportional to effort, applying a
prevalence adjustment also encourages appropriate case finding for
indicators whose denominator is under the control of the PCN. Consider
indicator HI-03, the denominator for which is the number of patients on the
learning disability register aged 14 and over. PCNs and their constituent
practices are responsible for adding patients to this register. The prevalence
adjustment encourages efforts to identify patients with a Learning Disability
and to add them to the register, as case finding increases earnings ability.
Bear in mind as we have covered in our article about the impact of QOF prevalence that prevalence will be recalculated and rebased each year (so you only win if you're constantly ahead of the curve) and that the increase in income almost never covers the additional work that will be required.
List size adjustment
The list size adjustment for a PCN is equal to the PCN list size
divided by the national average PCN list size, so PCNs get paid fairly depending on the number of patients they are serving.
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