GP Contract 2024/25 Overview

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 contracts.

The global sum payment is set at £107.57 per patient, calculated based on the weighted population figure. All practices operating under GMS, PMS, and APMS contracts will see an increase of £2.84 per weighted patient, unless stated otherwise in specific contracts.

On average, practices in England are managing around 9,964 patients each.


For the Quality Outcomes Framework (QOF), initial aspiration payments are now at 80% of last year's achievement payments, with each QOF point now valued at £220.62. This adjustment reflects the increase in average practice list sizes. The Network Participation Payment is calculated at £0.147 per weighted patient.


Each completed Learning Disabilities Health Check will earn practices £140, while payments for vaccinations and immunizations remain steady at £10.06 per service.


On the PCN side, funding specifics include £2.916 per patient, with added stipulations for Enhanced Access and other designated payments that emphasize collaborative and integrated care strategies.

Timeline of document release

28th February

Letter published by Amanda Doyle outlining arrangements for the GP contract in 2024/25.  This signalled that a number of indicators for QOF were to be "income protected" for the QOF year 2024/25.  PCIT produced a support article (now removed as time to complete the work as passed) for practices highlighting how to optimise their performance before the end of the 2023/24 contract year to ensure optimal performance for the 2024/25 year using resources available.

22nd March

26th March

QOF Business rules for 2024/25 were published.  PCIT analysed these and produced a guide to the changes which was made freely available within 48 hours of release.  The document signalled changes to blood pressure recording and the two cholesterol indicators which went from CHOL001 and CHOL002 to being CHOL003 and CHOL004

28th March

  1. QOF guidance for 2024/25 was published.  PCIT have analysed this and produced a support article highlighting the changes practices need to be aware of.
  2. Network Contract Directed Enhanced Service documents were published.  There are a number of these:
    1. Cover note: primary care networks- network contract directed enhanced service from April 2024
    2. Network Contract DES – Contract specification for 2024/25
    3. Network contract DES – guidance for 2024/25 in England – part A: clinical and support services (section 8)
    4. Network contract DES – 2024/25: part B guidance: non-clinical
    5. Network contract DES – template data sharing agreement
    6. Network contract DES – template data processing agreement
    7. Network contract DES – Sub-contract for the provision of services for 2024/25
    8. Network contract DES – primary care network adjusted populations spreadsheet
    9. Variation to the Network Contract Directed Enhanced Service Mandatory Network Agreement
  3. Enhanced service specification - weight management 2024/25

15th April

General practice vaccination and immunisation services: standards and core contractual requirements was published.  PCIT has analysed this document and produced a separate support article detailing the information practices need to be aware of (on 22nd April).

Key information

GMS Contract

Digital Telephony data requirements

The amendments to the 2023/24 GP Contract require that when practices enter into any new digital telephone contract, it must be procured through the national framework.
There is a requirement for practices to provide data on eight metrics through a national data extraction, for use by PCN Clinical Directors, ICBs and NHS England.
These eight metrics are:
  1. call volumes
  2. calls abandoned
  3. call times to answer
  4. missed call volumes
  5. wait time before call abandoned
  6. call backs requested
  7. call backs made
  8. average call length time

QOF

For a full analysis of the changes to QOF for the 2024/25 contract year see our separate support article highlighting all the changes in the QOF Contract guidance for this year

Income protection

This contract year has seen a further 13 indicators "protected", bringing the total to 32.  This includes:
  1. 19 disease register indicators
  2. 6 clinical indicators
  3. 1 publich health indicator
  4. 6 quality improvement indicators.
A total of 212 points have been "income protected".
To read more information and detail about this QOF income protection, see our separate support article which highlights how you may wish to approach this and the considerations you need to be aware of

Changes to CHOL003 and CHOL004

CHOL003
See our full CHOL003 support article for full details of this indicator

Indicator ID

Description

CHOL003

Percentage of patients on the QOF Coronary Heart Disease (CHD), Peripheral Arterial Disease (PAD), Stroke/Transient Ischaemic Attack (TIA) or Chronic Kidney Disease (CKD) Register who are currently prescribed a statin, or where a statin is declined or clinically unsuitable, another lipid-lowering therapy.


CHOL003 has been created to replace CHOL001.  There are some minor but important changes to this indicator:
  1. Patients who have had a haemorrhagic stroke are now excluded from this indicator
  2. Codes for inviting patients have been added to this indicator

CHOL004

See our full CHOL004 support article for full details of this indicator

Indicator ID

Description

CHOL004

Percentage of patients on the QOF Coronary Heart Disease (CHD), Peripheral Arterial Disease (PAD), or Stroke/Transient Ischaemic Attack (TIA) Register, who have a recording of LDL (Low-density Lipoprotein) cholesterol in the preceding 12 months that is 2.0 mmol/L or lower or where LDL cholesterol is not recorded a recording of non-HDL (High-density Lipoprotein) cholesterol in the preceding 12 months that is 2.6 mmol/L or lower.


CHOL004 has been created to replace CHOL002.  There are some minor but important changes to this indicator:
  1. Patients who have had a haemorrhagic stroke are now excluded from this indicator
  2. The main cholesterol result is switched from non-HDL to LDL
  3. the LDL target has been increased from 1.8 to 2.0mmol/L.  This means non-HDL will only count if your lab does not report LDL values.
  4. there are now PCAs (exception reporting) for maximal tolerated therapy, declined or unsuitable
  5. Codes for inviting patients have been added to this indicator (only if invited twice with no result or invited twice following a raised result)

Changes to Blood pressure indicators

Ambulatory blood pressure results are now recognised alongside home BP readings and will be subject to the lower 135/85 and 145/85 targets.

Cervical smears

There is clarification for this that the first two invitations are sent by the national call/recall service and that there should be third sent by the GP practice.

Primary Care Network Contract Directed Enhanced Service (DES) 

For a full analysis of the changes to PCN DES for the 2024/25 contract year see our separate support article highlighting all the changes in the PCN DES Contract guidance for this year
There are a number of changes within this contract specification, these include:

IIF Changes

    1. Reducing IIF indicators from 5 to 2 (retaining indicators on Learning Disability and FIT testing)
    2. Funding from the reduction in IIF has been put into the Capacity and Access plan
    3. Details of the Local capacity and access improvement payment
The last 3 areas are covered in more detail in Part B guidance: Non clinical which we have created a separate support article for.
The recycled funding from the IIF reductions is put into a LCAIP (Local Capacity and Access Improvement Payment) which has 3 separate elements for which PCNs can receive a third of the recycled funding each.  These are:
  1. Better digital telephony
  2. Simpler online requests
  3. Faster care navigation, assessment and response
More details of these can be found in the support article.

Other changes:

  1. Clinical director changes
    1. Changes to the responsibilities/accountability of Clinical Directors
    2. Joining Clinical Director and PCN leadership and management funding into the core PCN funding giving greater flexibility over use
  2. New roles eligible for ARRS funding
  3. A very much streamlined Service Specification - this is covered in much more detail in the separate support article about the document Part A: Clincial and support services
  4. Introduction of Integrated Neighbourhood Teams (INTs)
  5. Supervision of physicians assistants
  6. End PCN reallocation of unclaimed funding
  7. Requirement for the submission of data for workforce

Flu

Practices must sign up for the enhanced service in writing by 23:59 on 30th June 2024
All practices must sign up to CQRS by no later than 23:59 on 31st July 2024

Maximise administration of vaccines given to patients by 30th November 2024
The flu letter outlines the eligible cohorts.  The Green Book also defines these in the influenza chapter in "Immunisation against infectious disease"

Cohorts this year are:
  1. 6-65 years in clinical risk groups
  2. Pregnant women
  3. 65 and over
  4. Carers
  5. Close contacts of immunocompromised individuals
  6. Housebound patients
  7. Staying in long stay residential care homes or nursing homes or other long-stay health and social care facilities
  8. Locum GPs
  9. Frontline workers in social care settings employed by the following types of social care providers without employer led occupational health schemes:
    1. registered residential care or nursing home
    2. registered domiciliary care provider
    3. a voluntary managed hospice provider
    4. Direct payment (personal budgets) and/or Personal Health Budgets, such as Personal Assistants
  10. frontline patient facing staff working in general practice*
This means patients in these groups can only be vaccinated by their own GP 
This means patients in these groups can be vaccinated by any GP
*Practices can vaccinate their own patient facing staff but do not get paid for the vaccine, nor for administration if they do so

Weight management

Our separate support article about the local enhanced service goes through more detail of the requirements and how our folder 017 searches as well as HP202 and HP203 can help you to complete this.

For this enhanced service you need to:
  1. Maintain your Obesity register, at a minimum to the level it was at 31st March 2023
  2. Train your staff on having sensitive discussions about obesity
  3. Develop a practice based approach to the identification and support of people living with obesity (identify patients, get up to date weights, have conversations about referral)

More detail on finances?

The Statement of Financial Entitlements (SFE) sets out the payment terms for GPs for their core contract. See our separate articles on:
  1. Global sum income
  2. QOF Income including the impact of prevalence
  3. Income protection for the 2024/25 year
The Primary Medical Services Directed Enhanced Services Directions sets out the requirements and payment terms for practices choosing to provide the Network Contract DES, LD Health Check Scheme, Violent patients scheme and Minor Surgery Scheme.  See our separate article on:
All vaccines are subject to the same payment - £10.16 per vaccine

Weight management is funded at £11.50 per referral up to the maximum allocation per surgery.


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