Freeing up practices to support COVID vaccination – further details



Publications approval reference: C1050

An electronic copy of this letter, and all other relevant guidance from NHS England and NHS Improvement can be found here:

3 February 2021

Dear Colleagues

1. This letter provides further information for GP practices and commissioners on the measures set out in our letter of 7 January.

PCN Clinical Director support

2. The additional PCN clinical director support for January – March 2021 is equivalent to an increase in Clinical Director time per PCN from 0.25 WTE to 1 WTE for this period, and will be worth up to £32.5 million nationally. It will be made separately from the 0.25 FTE Clinical Director payment under the Network Contract DES, and must be calculated and paid manually outside CQRS. Where a PCN is eligible, the additional funding of £0.542 per patient for the quarter (using the PCN registered list size as of 1 January 2020, or a later date if this has been agreed with the commissioner) should be paid to the PCN’s nominated payee by the commissioner as soon as possible.

3. PCNs are eligible for this further support payment where at least one Core Network Practice is signed up to the COVID-19 Vaccination Programme Enhanced Service.

4. The payment will be made to the PCN’s nominated payee on behalf of the PCN and, similar to the Network Contract DES, must be deployed across the PCN in the manner which has been agreed by the Core Network Practices to support the leadership and management of the COVID response.

Income protection for Minor Surgery DES

5. Income protection arrangements for the Minor Surgery DES will apply from 1 January 2021 until 31 March 2021.

6. Local commissioners should make the monthly payments to practices for the Minor Surgery DES that they made for the corresponding period from 1 January to 31 March 2019.

7. No contract enforcement will be taken where no activity is done under the Minor Surgery Additional Service from 1 January 2021 to 31 March 2021.

Income protection for QOF

8. The income protection of QOF is being extended to cover the whole of the Quality Improvement Domain (74 points per practice) until 31 March 2021. Income protection is also being extended to the eight indicators related to prescribing detailed in Table 3 in the QOF Guidance linked below. Practices will need to meet the agreed conditions as set out in the existing QOF guidance which can be found at

9. An amendment will be made to the SFE to reflect the revised income protection arrangements for QOF and CQRS will be updated to reflect this in time to support end of year payments.

Investment and Impact Fund

10. In our letter of 17 September, we described the new Investment and Impact Fund and the opportunity for PCNs to achieve additional funding for performance against six indicators. Given high levels of flu immunisation and social prescribing referrals, and the continued priority attached to annual healthchecks for those with a learning disability, we anticipate strong PCN achievement.

11. Thank you for your continued hard work and rapid action to do all that is necessary to respond to this pandemic. Please contact with any queries on the above.

Yours sincerely,

Robert Kettell | Interim Director of General Practice | Contract and Workforce

Dr Ursula Montgomery | Senior Clinical Advisor: Primary Care

Annex: legal and accounting information

Where applicable, payments made under the income protection arrangements for the Minor Surgery DES and for the additional support for PCN Clinical Director will apply to GMS, PMS and APMS contractors with a registered list, and will be made to GP practices under Section 96 of the NHS Act 2006 (as amended) “Assistance and support: Primary Medical Services”. Payments made under the income protection arrangements for QOF will be made under amendments to the SFE.

In order to account properly for these payments as COVID costs, local commissioners may be required to request manual adjustment to implement the arrangements set out in this letter. Further financial and accounting guidance for commissioners.