This page explains what Primary Care Networks (PCNs) are, how they view claims submitted to CQRS, and the benefits of CQRS Local.
Primary Care Networks (PCNs) are groups of GP practices who work closely together. They are a key part of the future of primary care, working collaboratively with commissioners and providers to integrate health and care services to make the best use of resources locally.
A PCN covers a patient population of 30,000-50,000 patients. There are around 1,250 PCNs in England. GP practices are not mandated to join a PCN but will lose out on significant funding if they do not. [Source: NHS England]
GP practices become a core network practice by signing up to the network contract Direct Enhanced Service (DES) specification, which is an extension of the core GP contract and sets out the entitlements and requirements for a PCN.
A PCN network agreement sets out the arrangements between the core network practices of the PCN. This agreement includes how they will deliver DES requirements. Every PCN has a Clinical Director who provides strategic and clinical leadership. The requirements for a Clinical Director are set out in the DES.
PCNs and CQRS Payments
The nationally negotiated DES focuses on clinical indicators that support national priorities to support patient access and experience. PCNs focus on prevention and personalised care within their area, supporting patients to make informed decisions about their care.
Integrated Care Boards (ICBs) now have delegated responsibility from NHS England to commission primary medical services under PCN contracts and commission local enhanced services.
Under the PCN network contract, PCNs receive a core payment of £1.50 per registered patient, and receive various financial entitlements including:
- Clinical Director contribution
- extended hours funding
- care home premium
- additional roles reimbursements scheme (ARRS) workforce reimbursement
- investment and impact fund (IIF) incentive scheme.
Read more about service information and PCNs.
The Calculating Quality Reporting Service (CQRS) is an approval, reporting and payments system for GP practices and PCNs. It helps providers track, monitor and declare achievement for the Quality and Outcomes Framework (QOF), DES, and Vaccination and Immunisation (V&I) programmes [source NHS Digital]. Since 1 November 2020, CQRS has been managed by the NHS Commissioning Support Units.
PCNs and CQRS Claims
CQRS National facilitates payments in support of the PCN network contract and CQRS Local facilitates payments in support of locally enhanced schemes (LES) and local incentive schemes (LIS).
CQRS Local is a web-based portal. It enables providers and commissioners to manage claims for locally driven schemes that reflect local priorities. It streamlines the process of provider claims against local schemes, reduces administrative time, and ensures claims are trackable within a secure web-based platform.
No General Practice Extraction Service (GPES) or manual data entry is required for PCN Extended Hours Access payments, PCN Core Funding payments, PCN Clinical Director payments, or PCN Network Participation payments. These are automatically paid monthly to PCNs.
Manual declarations are required for the Primary Care Networks 2020/21 service and data is auto-extracted quarterly using GPES. Data is collected at GP practice level and reported in CQRS at both practice and PCN levels.
When GP Practice users submit a claim, it will be validated and then submitted to the commissioner for approval. If the claim fails validation, issues will display in an errors list for correction by the user. If a claim is rejected, the approver will enter a reason which helps ensure future claims are submitted correctly.
Benefits of CQRS for PCNs
Registered PCN users can access a dashboard in CQRS Local to track payment calculations and approval processing.
‘PCN View’ functionality allows PCN organisations to access:
- Dashboards to view all GP practices within their PCN including data submission details and payment declaration details
- Expanded reporting to view additional organisations.
In addition, ‘PCN Management’ functionality enables PCN organisations to add or update GP practice data within their PCN.
