Funding

Detailed guidance on current funding arrangements and allocations is provided in Primary care SDF and GP IT funding guidance 2021/22. Further published guidance will where applicable supersede funding guidance in this document.

Key actions

  • core and mandated GP IT Enabling Requirements (see Appendix A) are mandatory for local investment
  • investment for GP IT should be maintained and enhanced to support local plans to address the sustainability and quality of general practice, as outlined in the NHS Planning Guidance
  • investment in Enhanced Requirements should be commissioner led, and in consultation with general practices. It will align closely with plans for any local digital strategy and ICS which underpin the integration and transformation of care locally
  • Clinical commissioning groups (CCGs) are accountable for any financial risks associated with over-spending as part of their overall resource limit
  • clear financial protocols must be established and agreed between commissioners and delivery organisations to ensure CCGs remain in compliance with their financial obligations
  • CCGs and their GP IT Delivery Partners must follow all necessary financial guidance in relation to provision of GP IT services, including NHS England financial guidance. Where the commissioned GP IT Delivery Partner is not an NHS England body or a CCG they will be required contractually to support the CCG in its compliance with NHS England financial guidance in all matters relevant to GP IT services provided for example procurement support services
  • allocation of GP IT funding to CCGs is to support the provision of services, as outlined in this Operating Model, to general practices. If individual practices do not wish to receive such services from the CCG the CCG has no obligation to provide alternatives or to offer direct funding to the practice in lieu of such service provision.

Revenue funds

Core GP IT funding

GP IT revenue funding is included in CCG core baseline allocations. Priority must be given to funding the core and mandated digital requirements described in this Operating Model, for both practices and additional roles associated with PCNs, with any remaining funds used to support the wider transformation of digital primary care.

GP IT infrastructure and resilience

Additional revenue funding is allocated direct to CCGs to support infrastructure and resilience dealing with specific technology upgrade programmes which are key to providing safe, robust and secure IT services prioritising replacing some of the non-strategic temporary remote working solutions such as Remote Desktop Protocol systems, deployed during the Covid-19 pandemic but not appropriate as long term solutions. Instead, alternatives such as Virtual Desktop Infrastructure should be considered, while also allowing systems to apply flexibility

GP IT futures framework

The GP IT Futures Framework as part of the Digital Care Services (DCS) Catalogue is supported by a notional allocation of revenue funds held by NHS Digital to each CCG. These funds are based on registered patient capitations.

In using these funds, the CCG:

  • will procure Foundation Solutions to meet the Foundation Capabilities through the GP IT Futures Framework as first call on the funds
  • will only use the funds to procure solutions through the GP IT Futures Framework
  • may use remaining funds to procure remaining core and mandated Essential Clinical System Capabilities (see Appendix A) available through the GP IT Futures Framework
  • may use any remaining funds to procure solutions to meet enhanced clinical capabilities through the GP IT Futures Framework for use by their practices
  • NHS Digital holds a smaller amount of funding for GP IT Futures Framework to manage central activities such as standards payments

CCGs can also use local funds and baseline GP IT revenue funds to procure enhanced capabilities directly through the GP IT Futures Framework.

Individual practices are also able to procure any accredited solutions directly through the GP IT Futures Framework using their practice funds.

Assurance

Through the GP IT Futures Framework reporting capability NHS Digital will, for each CCG:

  • identify by each CCG that all core and mandated (essential clinical system) capabilities have been procured by the CCG for all its practices
  • identify that the total in year spend by the CCG flagged on the catalogue as centrally funded is within the value of the GP IT Futures notional allocation for the CCG.

In the event that assurance (i) above is not met NHS Digital will raise an escalation with NHS England who will investigate to confirm there is no breach of NHS GP Contract obligations.

Individual practices can refer to Appendix 1 – Summary of Services Table within the CCG-Practice Agreement to confirm services the CCG has procured for the practice.

Directions on coding and monitoring arrangements for CCG allocations is given in Primary care SDF and GP IT funding guidance 2021/22.

Online consultation systems

The programme supports the rollout and uptake of online consultations in general practice and ensures that software systems are in place to support this. From 1 April 2021 onwards, CCGs are expected to have a local contract(s) in place for online consultation and for video consultation systems. Accredited solutions should be selected, and these can be sourced through the new Digital Care Services DFOCVC Framework or Health Systems Support Framework (HSSF).

Digital first primary care

The Digital First programme fund launched in 2019 is a five-year revenue stream with a focus on the use of digital and online tools to improve access to the core elements of primary care services. This will support:

  • CCGs to embed and build on the digital transformation advances made in primary care as part of the pandemic response
  • all practices to deliver the core digital offer set out in the GP Contract and to increase use of digital tools by staff and patients, including through digital inclusion initiatives
  • all staff to work remotely
  • implementation in all PCNs and practices to streamline digital pathways to increase usability for patients, embed triage and support at-scale working
  • Digital First Accelerator projects that either test a new digital innovation or enable deployment of a tested solution in a new area or context, to solve performance or clinical priority issues. They must have the potential to be scalable across the system or regional footprint and to be sustainable over time.

Capital funds

BAU GP IT Capital: NHS England capital funding for GP IT will continue to be available for CCGs to access from NHS England Regional teams. Regional teams have delegated authority to set GP IT capital allocations for CCGs/health systems. This funding is designated to deliver, as first priority, systematic refresh of the GP IT estate for both practices and additional roles associated with PCNs, in line with the requirements of the GP IT Operating Model. Any remaining funds should be invested in technology advances that will improve the overall experience for staff and patients, as well as the security and cost-effectiveness of general practice and PCN IT infrastructure. Priority should be given to maintaining the GP IT estate necessary to support the core and mandated digital capabilities described in this Operating Model and compliance with the current local warranted environment specification (WES). Associated deployment costs for example installation, disposal, software licences should be considered within the capital bid. Depreciation costs arising from GP IT capital will continue to be funded centrally by NHS England.

Other revenue consequences arising from the growth of the combined GP and PCN IT estate will need to be included within CCG GP IT revenue plans. Practices need to discuss this with the CCG at an appropriate early stage.

Estates and technology transformation fund (ETTF) capital: ETTF is a multi-million pound investment (revenue and capital funding) in general practice facilities and technology across England. ETTF programme capital will continue to be available through Regional Teams to support both business as usual (BAU) GP and PCN IT investments and transformational estate schemes. It is expected this fund will continue to be available until 31st March 2022. CCGs will be responsible for communicating with their practices the detail of such investments and how these are expected to support general practice. Depreciation costs arising from ETTF capital will continue to be funded centrally by NHS England. Any other revenue consequences arising from the growth of the GP IT estate will need to be included within CCG GP IT revenue plans.

Microsoft Office 365 for the NHS licencing: £41.1 million of central capital funding was allocated in 2020/21 to regions on a fair share basis and accessible by CCGs via PID submission to regional teams available to pay for licensing of Microsoft systems across Primary Care. No further central funding is allocated for N365 licences any further requirements up until April 2023 should be supported from GPIT capital funds. Participating CCGs must fully implement all elements of Microsoft Office 365 licences for general practices by no later than 13 October 2021 in accordance with the Microsoft Office 365 for the NHS Participation Agreement. The agreement will then run until 30 April 2023.

CCGs responsible for procuring Microsoft Office 365 for the NHS licences for general practices and the migration away from Office 2010 will have considered a desktop installed version of Office 365 for those general practice users who require integration between the practice clinical system and Microsoft Word.

Compatibilities vary with each GP clinical system and the CCG should check with the relevant foundation supplier.

Other software applications in use by the practice may also rely on integration with MS Word, CCGs should therefore consider their entire estate as they plan their Microsoft 365 migrations. CCGs or practices (depending on who holds the licence) should check requirements with the relevant system supplier.

For practice staff and organisations who only use MS Word as a “standalone” application (without integration) CCGs may have considered the cheaper restricted E3 licence.

CCGs should start planning for the impact on Office application use in practices after 30 April 2023 when the current NHS participation Agreement ends. These plans should reflect NHS policy and guidance as it becomes available.

Time limited funding initiatives

To enable specified programmes additional allocations of non-recurrent funds will continue to be released to CCGs to support such programmes. These funds should be used to support the identified programme. Assurances will be secured through the relevant programme generally based on deployment and capability outcomes. CCGs should take into consideration financial impacts of any new systems or infrastructure deployed and the continuity in provision once the time limited funding ceases. Any decision to enhance the CCG allocations to support any recurring costs after the transition period will be made on a programme by programme basis.

Direct funding

CCGs have delegated responsibility to provide by (either directly or by commissioning) digital services for their practices as defined in this Operating Model. CCGs should not offer GP IT funds directly to general practices to enable them to provide or commission these services, unless advised otherwise for a specified GP IT purpose in this document for example reimbursement to practices for clinical system training. Where a CCG considers direct funding to practices for any such specified service, whether funded in advance or by reimbursement against an approved claim, the following requirements should be adhered to:

  • CCG compliance with its SFIs
  • compliance with NHS England financial guidance
  • compliance with other standards for example cyber and data security, clinical safety, GP Connect Products
  • how value for money is assured when procurement is disaggregated. The CCG remains responsible for compliance with the standards in this Operating Model
  • that other practices, not receiving direct funding for GP IT from the ICB, are not disadvantaged
  • GP IT Funding is not awarded directly to another party acting on behalf of the practice (for example sub-contracted), unless that party has been commissioned by the CCG to provide GP IT Services following appropriate procurement process.

Other sources

The designated funding allocations above are made to ensure CCGs are able to provide, as a minimum, the core and mandated digital requirements required by general practice as defined in this Operating Model. Any funding surplus to meeting this requirement should be used to provide the locally prioritised enhanced digital requirements. CCGs should also consider the use of any other locally available funding sources to support enhanced digital capabilities which reflect the local digital roadmap for service improvement and transformation in all local care settings.

Continuity and digitisation of GP records

Using the learnings from the pilot projects for digitisation of paper records, the strategy for the digitisation of Lloyd George records is under review to ensure that the most effective delivery model is implemented to meet the GP contractual commitment to digitise GP patient records at the point of care by March 2022.

Out of scope

CCGs are expected to ensure that the commissioning and procurement of digital services locally does not duplicate existing funding sources or provision. General practice business requirements should not be funded using CCG allocations.

The General Practice Global Sum is out of scope. It is used to directly fund GP Contracts and will include services and utilities such as those listed in this document as General Practice Business Requirements.

Dispensing practices (approximately 1,000) operating under NHS England Standard Contract arrangements for pharmaceutical dispensing regulations require software and digital infrastructure to operate the dispensing function. These services are outside the scope for the receipt of GP IT digital services under this Operating Model. Dispensing practices are in scope for the GMS/PMS/APMS contracts to provide essential services.

Table 2: Funding sources and application supporting Digital Primary Care

Funding Type Purpose
Core GP IT Revenue Revenue To provide/commission GP and PCN IT services with 1 priority on core and mandated GP IT Enabling Requirements.
GP IT Infrastructure and Resilience Revenue Additional funding direct to CCGs to support infrastructure and resilience dealing with specific technology upgrade programmes which are key to providing safe, robust and secure IT services for example replacing some temporary remote working solutions deployed during the pandemic.
GP IT Futures Framework                 Revenue Notional Allocation To call off accredited solutions from GP IT Futures Framework with priority for Foundation and core and mandated capabilities.
GP Online Consultations Revenue To support the rollout and uptake of online consultations in general practice.
Digital First Primary Care Revenue A five-year revenue stream with a focus on the use of digital and online tools to improve access to the core elements of primary care services including remote access for GP staff.
BAU GP IT Capital Capital GP and PCN IT infrastructure/equipment priority to support Core and Mandated Requirements.
ETTF Capital Capital To support both Business As Usual GP and PCN IT investments and transformational estate schemes.

Guidance contents

Download a PDF copy of ‘Securing Excellence in Primary Care (GP) Digital Services: The Primary Care (GP) Digital Services Operating Model 2021-2023’