What does the new GP contract mean for your PCN?

The GP Contract update has just been published.

It includes the Primary Care Network (PCN) DES, the Investment and Impact Fund update, the update to the Quality and Outcomes Framework (QOF).

There are 11 documents in total and it’s an awful lot for time-pushed GPs, GP Federations and Primary Care Networks to get through when they’re already overwhelmed but I’ve burned the midnight oil to plough through them all so you don’t have to.

This is one of the key areas I am supporting clients with at the moment and all the Primary Care Networks under my wing have quarterly reviews with me due in April and May. I deliberately time it like that so we can address whatever changes are in the update and identify any opportunities arising from that.

The big issue for Primary Care Networks (PCNs) in the 2023 GP Contract Update is understanding the ask.

At this time of incredible, sustained pressure, how can PCNs get a grip on what is being asked of them this year – and how are they going to deliver it?

The first step is for practices and GP partners to work out how they’re going to collaborate throughout this year to deliver what is being asked of them.

Two networks I work with are doing that right now, they’re refreshing their values to make sure they are all completely aligned behind a single vision and that everybody is pointed in the same direction (read my blog on what happens if that’s not the case here). What you definitely can’t have is a PCN with five member practices and five different visions.

So, whenever you get a new ask, it’s a good time to check in on that, to make sure everyone is aligned.

Investment and Impact Fund Indicators are drastically reduced

In this latest update we’re going from 36 indicators in the Investment and Impact Fund down to five and the Quality and Outcomes Framework (QOF) has been streamlined by about 25%. But new things have been introduced which will leave PCNs wondering how to respond to them.

The big issue in the new update is access. There’s a huge focus on patients being able to access care and GP practices now being told patients should be offered an assessment of need, or signposted to an appropriate service, at first contact. As an example, practices will no longer be able to tell patients to ‘ring back later’. That is going to need a plan – we risk problems ahead that might affect PCN performance and relationships.

The five tests that frame your new PCN projects

In my work with the networks, we have five tests we apply to the projects we’re getting off the ground:

  1. Does it fit the business plan you’ve got or does it need a refresh?
  2. Will this genuinely improve patient outcomes significantly over what you’re doing currently?
  3. Does it reduce workload for GPs, partners or the wider practice team?
  4. What impact does it have on income? An awareness of that is, of course, absolutely vital.
  5. Have you got the workforce to be able to deliver this?

Number five is the key test because without the workforce, whatever you take on is going to be a real challenge. Once you know what the ask is, have you got the workforce to deliver it? If not, how do you put the workforce in place? That question needs to be part of your overall network workforce strategy.

And of course, part of that is the Additional Roles Reimbursement Scheme (ARRS), which I’ve written about here. Beyond that, you need to work out your ongoing relationship with your integrated care system and the board within that. You must make sure all your wider stakeholders are fully engaged.

Share your project case studies to work together towards a positive outcome

Within my work coaching PCNs, GP Federations and GP Practices I often share what others are doing well with regards to these updates so that clients can easily visualise how to bring these practice ideas to life. It’s part of the benefit of contracting my services – I can share best practices from clients in Warwickshire, Leicestershire, London, Bath and many other parts of the country.

Sometimes that might also mean looking at learnings from situations where things looked like they were headed downhill, and how I have worked with my clients to solve problems before they became a major issue.

From there, it’s all about individual plan of the client. How will they execute it? Who’s going to be responsible? Who will be accountable? Who do they need to consult and who are they just informing? Can they draw up a really clear trajectory for monitoring and evaluating the progress that they make? As the ask gets bigger and bigger, so does the need to collaborate. Develop a great plan and then work together toward a positive execution. And if you need any help from someone who has been through that process countless times, you know where to find me. Please feel free to connect with me on Linked In if you have any questions around this at all.


Scott McKenzie helps GPs, PCNs and GP federations build sustainable and resilient practices and organisations that thrive. If you want to know how to double your revenue and reduce the overwhelm, Scott can share these processes with you too. Schedule a call today.