Working collaboratively with the national primary care team, we developed a series of innovative features to inform the review and refresh of the Investment and Impact Fund (IIF) incentive scheme. The scheme uses incentives to encourage PCNs to think about doing things differently.
The IIF is an incentive scheme supporting the delivery of high-quality care through PCNs to their population to meet a set of priority objectives. The scheme is worth £150m in 2021/22, rising to £225m in 2022/23.
NHSE/I looked for analytical support and subject matter expertise to contribute to the development of new PCN service requirements, PCN indicators and the Investment and Impact Fund.
Working alongside the national primary care incentives & outcomes team in NHSE/I, we supported the development of the indicators, thresholds and valuations included in the Investment and Impact Fund (IIF). We:
- Built the core IIF model to verify payment calculations
- Analysed the implications of different thresholds and indicator valuations for marginal incentives
- Generated baseline performance data in innovative ways. This included combining data sources, and doing groundbreaking analysis of record-level GP data
- Developed and negotiated the IIF and Network Contract DES indicator definitions with NHS Digital and the CSU collaborative
- Monitored and tracked indicator development and decisions
- Supported the development of the IIF guidance
- Trained NHSEI analysts on the use of GP data for Pandemic Planning and Research (GDPPR)
- Submitted SNOMED code requests to the NHSD terminology team to support new data collections
- Participated in task and finish groups to develop new ways of working where we encouraged self-reflection to support the workshop outcomes.
The IIF aims to:
- Improve prevention and tackle health inequalities
- Support better patient outcomes in the community through proactive primary care
- Support improved patient access to primary care services
- Deliver better outcomes for patients on medication
- Help create a more sustainable NHS
Working collaboratively with the national team, we developed a series of innovative features that were incorporated into the scheme. This included indicators based on new data sources, new payment calculation methods, indicator monitoring processes, and the development of thresholds.
The development of this baseline data and our impact modelling approaches formed the basis of negotiations with key stakeholders leading to the publication of the updated IIF scheme.
The IIF scheme and PCN plans for 21/22 - 22/23 were published in a letter from NHSE/I on 23rd August 21. Details of the IIF indicators, thresholds, valuations and data sources for 22/23 as well as for the remainder of 21/22 can be found in Annex B.
The impact of the changes in the IIF scheme is succinctly stated by Matthew Skellern
'SCW CSU is recognised as having been a major driver of the creation and expansion of the IIF, to the point where it is now an important feature of the general practice payments landscape, and a key vehicle for delivery of commitments set out in the NHS Long Term Plan and Investment and Evolution, the five-year GP contract framework.'
Matthew Skellern, Head of Incentives & Outcomes: General Practice & Primary Care Networks, NHS England and NHS Improvement