Introduction

1. NHS England provides service development funding (SDF; sometimes also referred to as system development funding) for Integrated care boards (ICBs), as additional programme funding on top of ICB baselines. This document provides additional guidance for the spend of primary care SDF and agreed funding set out in the Update to the GP contract agreements 2024/25: Financial implications published in March 2024 and in line with Priorities and operational planning guidance 2024/25.
2. The Priorities and operational planning guidance 2024/25 confirms the continuing priority focus on delivering 3 recovery plans: primary care, urgent and emergency care, and elective and cancer care.
3. In 2024/25, ICBs should therefore spend primary care SDF on supporting primary care to make the changes and deliver the commitments set out in the Delivery plan for recovering access to primary care, and the update to this delivery plan (published in April 2024), with the objective of improving access to primary care services and particularly to general practice.
4. Primary care SDF should be ringfenced for primary care priorities and should not be used to fund business as usual staff costs or other ICB costs.

Primary care SDF 2024/25

5. The primary care SDF funding available in 2024/25 is as per Table 1 below. For ICB funding breakdowns, see Appendix 1. The rest of this document sets out how this funding should be spent and managed.

Table 1: Primary care SDF 2024/25

6. The primary care transformation allocation includes funding that in previous years had been separated into different allocations (such as local GP retention fund, training hubs, recruitment and retention funding, and digital first primary care), but is now combined into a single transformation allocation.
7. In 2023/24 the primary care transformation allocation included £43m for primary care network (PCN) leadership and development. In 2024/25 this funding has been added to ICB baselines rather than forming part of primary care SDF, but it should still be used to support PCNs.
8. The national General Practice Fellowships, Supporting Mentors and New to Partnerships Payments Schemes are closed to new entrants but funding is provided in 2024/25 due to commitments in these schemes carrying over from previous years.
9. ICBs and NHS England regional teams will have supportive discussions over the financial year on delivery, progress and issues to help ensure best use and impact of the funding. Where it is preferable for some primary care SDF to be held and spend to take place at NHS England regional level to achieve economies of scale, that can happen with the agreement of ICBs in that region.

Primary care transformation funding

10. The delivery plan for recovering access to primary care focuses on 2 central ambitions for patients:

• tackling the 8am rush and reducing the number of people struggling to contact their general practice
• for patients to know, on the day that they contact their general practice, how their request will be managed

11. To deliver these ambitions, general practice is asked to move to a modern general practice approach (alongside other actions being taken as part of the plan) to support better alignment of capacity to need and enable a more sustainable general practice. ICBs should use primary care transformation funding to provide support for general practice in implementing the modern general practice model and, through doing so, deliver an improved experience of access for patients, better continuity of care where most needed and improved job satisfaction for staff. As a sustainable, engaged workforce is critical to delivering the ambitions set out in the delivery plan and improving access for patients, ICBs are expected to ensure that the support provided has a positive impact on recruitment and retention of staff.
12. ICBs should work with general practices to understand their needs, using the support level framework (SLF). This should take place via facilitated conversations with practices to complete the framework, leading to the identification of priority areas for improvement. Where possible, ICBs should also work with PCNs to identify their needs using the PCN level SLF. ICBs should bring together themes from the SLF conversations, workforce and other data, and local intelligence to design interventions and support.
13. The General Practice Improvement Programme (GPIP) remains in place as a national offer for 2024/25 and ICBs should nominate practices to receive hands on, ‘practice level support’ from GPIP where that will be of most benefit and will work in alignment with the ICB’s approach. However, this should be in addition to and not instead of providing local support using SDF. ICBs should work with training hubs and other partners to develop and provide local transformation support. Local support should build on learning, evidence, best practice and resources shared by national teams.
14. NHS England will work with ICBs in 2024/25 to establish a commissioning approach for primary care transformation support (for example, a specification and provider framework), to help systems provide effective local support. This will aim to enable scaling of learning from GPIP and strengthen locally owned delivery of transformation support by ICBs.
15. In addition to progressing the implementation of the modern general practice approach, ICBs should use primary care transformation funding to enable better integration across primary care, and to support the development of PCNs, integrated services and neighbourhood teams centred around local population health needs. The focus should be developing a strategic approach to supporting primary care that delivers the most impact for patients and staff for the available resources. ICBs should continue to evaluate the impact of local offers, including equalities impacts.
16. As set out in the delivery plan update and actions for 2024/25 (April 2024), ICBs are expected to report on progress in delivering the commitments in the delivery plan via their October or November 2024 ICB public board meetings.

Workforce funding

17. In addition to the workforce funding, which has been amalgamated into the primary care transformation funding, separate budget lines are provided to meet specific commitments as follows:

Additional Roles Reimbursement Scheme (ARRS)

18. The ARRS provides funding for 26,000 additional roles for PCNs to create bespoke multidisciplinary teams. It also offers opportunities for practitioners to join primary care with a supported and more diverse career. Funding from the scheme can be used to reimburse roles recruited into PCNs under the Network Contract DES.
19. In 2024/25, £907m of ARRS funding is included within ICBs’ baseline allocations; and £534m is held centrally within primary care SDF. Each ICB’s share of this central allocation is available for release when needed, subject to regional and national approvals. See Appendix 2 for ICB ARRS allocations.
20. ICBs are expected to use ARRS funding to continue to increase the number of additional roles in primary care, ensure all PCN claims for funding are made and approved via the online portal and NWRS returns are completed by 100% of practices and PCNs, and ensure effective support is provided to PCNs to recruit, embed and retain new roles as specified in PCN DES documentation and guidance related to the scheme. 

General practice recruitment and retention programmes

21. £44.3m is available nationally for 2024/25 for all associated costs in relation to participants who joined the General Practice Fellowship scheme on or before 31 March 2024. This includes participant salary reimbursement and oncosts, provision of learning and mentoring, as well as programme delivery and oversight costs. Funding allocated in Q1 will be based on PCMS data submissions and previous activity. Actual activity and allocations will be reviewed during 2024/25 and final allocations may be adjusted to reflect actual expenditure. Additional funding will be provided in 2025/26 for those on the final year of the scheme.
22. The New to Partnerships Payments Scheme (N2PP) and the International GP Recruitment (IGPR) programmes remain closed to new applicants. In 2024/25 there is £5m available nationally for N2PP training costs that run into this financial year. This funding will be held centrally and paid based on successful claims under the scheme. Residual funding is also available nationally to support the costs of GPs already on the IGPR programme to complete it.
23. Following reforms to both Return to Practice (RtP) and International Induction Programme (IIP), funding is available centrally to reimburse practices for eligible GP salaries and on-costs in line with the scheme.

General practice IT (GPIT) funding

24. GPIT funding includes:

• GPIT revenue embedded as part of ICB core baselines
• funding held centrally for spend on accredited GPIT systems (including core clinical systems but also other systems)
• capital funding embedded in overall NHS England capital allocations

None of the above funding is primary care SDF but it is mentioned in this document for information.

• GPIT infrastructure and resilience funding – this is part of primary care SDF

25. The total GPIT revenue for 2024/25 embedded in ICB baselines is £280.1m. The indicative shares by ICB are set out in Appendix 3. This funding is designated to deliver, as first priority, the core and mandated requirements of the GPIT operating model for both practice and additional roles staff working with PCNs. Any remaining funding should be used to support the wider digital transformation of primary care.
26. Funding held centrally for spend on accredited GPIT core clinical and other systems is provided based on a notional allocation per ICB of up to £1.70 per patient per annum (which is currently under review). This funding is required to be spent on products included in the digital care services catalogue and associated frameworks.
27. There will be additional funding available in 2024/25 to support ICBs to provide general practice with access to improved digital consultation, messaging and booking, and to include demand and capacity management tools. The total funding of £48m available for 2024/25 equates to an average of 76p per patient; however, requests up to a maximum annual equivalent of 93p per patient will be considered with funding allocated to ICBs on a first-come, first-served basis once full details of costs have been received. This funding was made available across 2023/24 and 2024/25 as part of the delivery plan for recovering access to primary care, and ICBs should contact the national Commercial and Procurement Hub to access support prior to any buying.
28. ICBs will be expected to work with PCNs and practices to decide which tools from the catalogue will best enable them to shift to the modern general practice access model and to implement and sustain improvements.
29. Capital funding is communicated separately and is subject to specific processes and governance.
30. In addition to the above, £13 million GPIT infrastructure and resilience funding from primary care SDF will be allocated on a fair-shares basis to ICBs in 2024/25, via a single payment in Q1. This funding should be used by ICBs for investment in specific technology upgrade initiatives aligned with the requirements of the GPIT operating model.

Dental and eye health

31. As part of primary care SDF, funding is available to support oral health check-ups in residential special education settings, and sight tests in special education settings, including day and residential schools.

Community pharmacy PCN engagement roles

32. The community pharmacy PCN engagement lead role has been established to support the regional implementation of the pharmacy requirements in the delivery plan for recovering access to primary care, including supporting the implementation of the Pharmacy First Service and expanding the Blood Pressure Checks Service and Pharmacy Contraception Service.
33. NHS England is funding this role from 1 April 2024 until 31 March 2025. The funding is provided per PCN for ICBs to manage delivery at a local level. The funding is based on the number of PCNs within the ICB, with this number taken from official ODS data from December 2023.
34. Funding will be transferred to ICBs as part of the primary care SDF allocations in Q1 2024/25 so that the roles can be established as detailed above.

Assurance

35. Assurance requirements will be commensurate with the funding allocated. ICBs will be asked to report on how many PCN engagement leads are in place, and give an overview of their activity and impact half way through the year in September and then again in March 2025. NHS England regional senior pharmacy integration leads will monitor uptake and collate reporting nationally to support oversight and evaluation of their success.
36. Further details can be found in the guidance document

Other relevant funding

37. PCN funding continues for clinical directors and is included in primary medical care allocations. This is further supplemented by PCN leadership and development funding (£43m) included in ICB baselines (as mentioned above).

• In 2024/25, PCNs will receive monthly funding via the Investment and Impact Fund (IIF) Capacity and Access Payment to support improvements and the move to modern general practice, plus additional payments (the Capacity and Access Improvement Payment) conditional on putting in place particular components of modern general practice (see arrangements for the GP contract in 2024/25 letter).

39. There is also £44m transition cover and transformation support funding available for a second year in 2024/25 as part of the delivery plan for recovering access to primary care. ICBs should provide this funding to practices to support them in implementing a modern general practice approach.

Appendix 1: ICB primary care SDF allocations

Appendix 2: ICB ARRS funding

Appendix 3: Indicative ICB GPIT revenue shares within core allocations

Publication reference: PRN01297