IIF Funding structure

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.





    • Related Articles

    • GP Contract 2024/25 Overview

      The latest GP Contract information is available on the NHS England GP Contract Hub What do I need to know about this contract year? Overview Starting from April 1st, there will be updates to the GMS contract, which will also affect PMS and APMS ...

    • Global sum income

      This is a complex area, PCIT have spent hours digesting the latest Statement of Financial Entitlements (SFE) document and simplified and summarised this in a series of articles with hints and tips. To calculate the global sum income, your registered ...

    • Accessing the PCIT Learning Account

      To access the Primary Care IT Learning account, click on the "Learning Account" on the top right menu: If you don't have access to the Learning Account, you will see the following page:   When logged in correctly, you will see the learning hub: If ...

    • QOF Income including the impact of prevalence

      Income Protection For the year 2024/25 a number of QOF indicators have been "income protected". See our separate support article for more details about this. Aspiration payments Aspiration payments are funded at 80% of the previous year's unadjusted ...

    • Income protection for the 2024/25 year

      This contract year has seen a further 13 indicators "protected", bringing the total to 32. This includes: 19 disease register indicators 6 clinical indicators 1 public health indicator 6 quality improvement indicators. A total of 212 points have been ...