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GP Contract Changes 2021/22

GP Contract Changes 2021/22

Supporting General Practice 2021/22 letter was issued by NHSEI and BMA on 21st January 2021.

This letter sets out proposed changes to the GP contract.  Most of these changes had previously been agreed, but due to Covid-19 pandemic many of the changes have been reduced or postponed.

The letter and discussions confirm that these agreed changes are still open to amendment to allow improved Covid-19 capacity.




Additional Roles Reimbursement Scheme (ARRS)

  • Will increase from maximum £430m in 2020/21 to maximum £746m in 2021/22
  • Will include extra roles: paramedics, advanced practitioners, and mental health practitioners

ARRS Mental Health Practitioners

  • New funding model for Mental Health Practitioners to be employed by PCNs and mental health trusts with cost shared 50/50, and to be deployed within the PCN

PCN DES Specifications

  • Current PCN specifications to deliver Extended Access, Structured Medication Reviews (SMR), and Enhanced Health in Care Homes (EHCH), social prescribing, and early cancer diagnosis continues
  • New specifications due to be introduced in April 21 delayed, but unsure when these will be introduced: Cardiovascular Disease Diagnosis and Prevention, Tackling Neighbourhood Inequalities, Anticipatory Care, and Personalised Care.

PCN DES Investment and Impact (IIF)

  • IIF funding to increase to £150m
  • IIF indicators for 2020/21 will continue for 2021/22: seasonal flu uptake, learning disability health checks, social prescribing referrals, and medicines safety
  • New IIF indictors which had been for introduction in April 21 will now be delayed: supporting improved access to general practice, reducing carbon footprint, and shared savings with altered pathways

PCN DES Access Scheme

  • Existing access schemes, Extended Hours and Improved Access,  were due to merge in April 2021, and be provided by PCNs , this has now been delayed to April 2022
  • If PCNs, practices, and CCGs want to introduce this change sooner, this can be done with local agreement


  • Will remain largely unchanged for 2021/22
  • Childhood Immunisations DES will be replaced by a Vaccs and Imms domain in QOF
  • QI modules not completed in 2020/21 will be rolled over to 2021/22: Learning Disabilities and Supporting Early Cancer Diagnosis
  • New funding for extra Mental Health indicators to increase mental health physical health checks

Terms and conditions of practice staff

  • There will be a data collection to understand practice staff terms and conditions of employment, to focus upon gender pay gaps

Core digital

  • Definition of what practices must provide for digital access
    • Practices to offer and use online consultations that can be used by patients, carers and by practice staff on a patient’s behalf, to gather submitted structured information and to support triage, enabling the practice to allocate patients to the right service for their needs
    • The ability to hold a video consultation between patients, carers and clinicians
    • Two-way secure written communication between patients, carers and practices
    • An up to date accessible online presence, such as a website, that, amongst other key information, links to online consultation system and other online services prominently
    • Signposting to a validated symptom checker and self-care health information (e.g. nhs.uk) via the practice’s online presence and other communications
    • Shared record access, including patients being able to add to their record
    • Request and management of prescriptions online
    • Online appointment booking

Cervical screening

  • To move from being an additional service to being an essential service

Electronic Repeat Dispensing (eRD)

  • Requirement for patient consent removed under pandemic regulations to become permanent