Agenda item

NHS Operational Planning and Contract Guidance 2020/21

Chris Edwards, RCCG - Presentation on the planning and contract guidance for the NHS Long Term Plan


Chris Edwards, RCCG, gave the following powerpoint presentation on the planning and contract guidance for the NHS Long Term Plan:-


The People Plan ‘package’ including

-          50,000 WTE nurses

-          Maintenance grants/university expansion

-          International recruitment

-          Retention and return to practice

-          6,000 WTE GPs

-          4,000 training places

-          International graduates

-          26,000 other primary care professionals

-          Pensions Tax Reform


ICSs and System Planning

Two Core Roles

-          System transformation

-          System performance


-          Population health management, service redesign and digitisation

-          Capital and estates plans at a system level


Mental Health

-          Additional funding in 2020/21 for Community Mental Health provision for adults and older adults

-          By March 2021, all MH should work with their Primary Care Networks to organise and deliver services together

Learning Disabilities and Autism

-          Support for people with learning disabilities and/or autism in the community rather than in hospital


Elective Care

-          On 31st January, 2021, waiting lists should be lower than that on 31st January, 2020 (ICS Level)

-          In 2020/21 additional choice at 26 weeks

-          Rotherham historically performed strongly in this area


Urgent and Emergency Care

-          Material improvement in A&E performance against a 2019/20 benchmark

-          All to reduce general and acute bed occupancy to a maximum of 92%


Outpatient Transformation

-          Planned reduction by a third in unnecessary outpatients activity

-          Providers income maintained through payments for advice and guidance and uptake of non-face to face consultations

-          In 2020/21, video consultations in major outpatient specialties



-          Additional funding in 2020/21 to support roll out of rapid diagnostic centres and the targeted lung health checks programme

-          28 day faster diagnosis standard will be challenging



-          The guidance places significant emphasis on measures to improve population health

-          Alcohol Care Teams and Smoking Cessation support will be expanded in selected sites

-          Low calorie diets will be piloted in 10 systems to support people with Type 2 Diabetes to achieve remission

-          Department of Health and Social Care is considering making flu vaccination mandatory for NHS staff


Climate Change

-          NHS to develop a national de-carbonisation and climate change plan

-          Ending business travel reimbursement for domestic flights within England, Wales and Scotland

-          Purchasing 100% renewable electricity by April 2021

-          Replacing lighting with LED alternative during routine maintenance


Primary and Community Services

-          Overall spending by CCGs on primary medical care, community services and continuing healthcare, should continue to increase

-          Primary Care Networks’ (PCNs) development will need to accelerate through 2020/21

-          CCGs will support to:-

Redesign workforce and recruit to new roles

Improve patient access and waiting times

Set up online consultation systems

Provide information about A&E attendances by the PCNs patient population

-          In addition PCNs will need to:-

Work with community providers (including pharmacies)

Provide crisis response services, guaranteed 2 hour home response appointments


Primary Care Networks

-          Major enhancements to the additional roles

-          Reimbursement Scheme

6,000 extra staff will be funded under the Scheme

More roles will be added to the Scheme from April 2020 in addition to those previously agreed: pharmacy technicians, care co-ordinators, health coaches, dieticians, podiatrists and occupational therapists.  Mental health professionals will be added from April 2021

Reimbursement for the 26,000 roles increases from 70% to 100%

PCNs are encouraged to take immediate action to recruit


Increasing the Number of GPs

-          A raft of measures to aid GP training, recruitment and retention to help meet the target of 6,000 extra doctors in Primary Care

-          GP trained numbers will increase from 3,500 to 4,000 a year from 2021

-          A 2 year Fellowship in General Practice will now be offered as a guaranteed right to all GP trainees on completion of their training

-          A new national Mentors Scheme will offer highly experienced GPs the opportunity to mentor GPs in return for a minimum time commitment

-          The New to Partnership Payment guarantees first-time partners a £20,000 one off payment, plus £3,000 funding for business training

-          The Induction and Refresher Scheme will be expanded and enhanced to provide more support to GPs returning to general practice

-          A new Locum Support Scheme will provide greater support to locum GPs in return for a minimum time contribution


Primary Care

-          A renewed focus in improving access including a new GP Access Improvement Programme which will initially seek to cut the longest waits for routine appointments.  More people working in General Practice will help achieve 50M more appointments in General Practice.  An improvement appointments dataset will be introduced in 2020, alongside a new, as close to real time as possible, measure of patient experience.  At least £30M of the £150M PCN Investment and Impact Fund in 2021/22 will support improved access for patients, rising to at least £100M of the £300M Fund in 2023/24


Primary Care

-          Vaccination and immunisation payments will be overhauled to support improved vaccination coverage

-          Further improvements to QOF including significant reforms to the asthma, COPD and heart failure QOF domains

-          A universal post-natal check for new mothers introduced backed by £12M of additional funding

-          The Structured Medication Review and Medicines Optimisation, Enhanced Health in Care Homes and Supporting Early Cancer Diagnosis PCH Service specifications will be introduced in 2020/21.  The remaining 4 – CVD diagnosis and prevention, tackling inequalities, personalised care and anticipatory care – will be introduced in 2021/22.  From April 2020 every PCN will offer a Social Prescribing Service

-          Incentives under the new Investment and Impact Fund introduced in 2020/21 to increase update of LD health checks, seasonal flu jabs, Social Prescribing referrals and improve specific aspects of prescribing


A full version of the Guidance could be found at


Discussion ensued with the following issues raised/clarified:-


·           Climate Change was a big feature currently as well as how CCGs worked and operated and had policies and practices which were carbon neutral – future issue for the Board to consider

·           The Council had a draft Climate Change action plan which, if approved, would commit the Council to be carbon neutral by 2030.  There was a commitment to work with other partners

·           The Primary Care Networks were in their infancy

·           The success of any international recruitment drive was an unknown factor at the present time

·           Early feedback from the Rotherham Health App was very promising but consideration should be given to a promotional launch


Resolved:-  That the presentation be noted.

Supporting documents: