Monitoring the Impact and Investment Fund (A Case Study)

We recently shared The Primary Care Network DES | A checklist of what to focus on in Q2. In this blog, we shared that one of the recommended activities was to take some time to review the progress made in relation to the Impact and Investment Fund (IIF).

Below is one example of how we monitor the Impact and Investment Fund in practice.

Also, take a look at our other blog 11 Top Tips to Manage The Primary Care Network Impact and Investment Fund.

DISCLAIMER: Please note, we are just providing an example.

Every network is different, and different strategies will be needed to best suit the running of your network.

What is the Impact and Investment Fund (IIF)?

• The IIF is an incentive scheme for primary care networks to come together to work to improve and enhance care for their patients.

• In 2020/2021, when the scheme first launched, there were six indicators. From the 1st of April 2022, there are now 28 indicators.

• The scheme offers a financial incentive to be reinvested into the PCN, and there is freedom in how you choose to allocate the financial investment.

Where can I find NHS guidance on the Impact and Investment Fund for 2022/2023?

• NHS England: https://www.england.nhs.uk/wp-content/uploads/2021/08/B0828-iii-annex-b-investment-and-impact-fund-21-22-22-23.pdf

• The 2022/23 Network Contract directed Enhanced Service Specification.

If you are unsure of how to approach monitoring the IIF, we thought we would share the approach that LMN PCN took.

LMN PCN is based in Kent and Medway and comprises of 2 practices based over three sites.

Currently, LMN PCN includes the following staff members. Whilst the organisational chart looks very linear, the team work very collaboratively, with a mix of the team working on-site, remotely and with community partners.

The approach

1. We met face to face for 3 hours.

2. The meeting included refreshments, and we met off-site at a local church. The venue and refreshments were funded using an underspend of the 21/22 development fund.

3. Before this IIF meeting, we discussed how we could redesign their frailty service and aligned this to the Enhanced Care in Care Home DES.

4. Luke, the Pharmacy Technician, ran the IIF audit and took us through every point of the Impact & Investment Fund.

5. The meeting also included the Paramedic Practitioner, two Pharmacists, the PCN Manager, Care Coordinator, the PCN Clinical Director and a GP.

6. We used the IIF Ready Reckoner created by a PCN Manager, Kate Burke. We printed it off on A3 pieces of paper.

7. The clinical system used by both practices in the PCN is EMIS.

8. We discussed what we had achieved to date.

9. We also discussed; what aspects we needed to be mindful of, who would be instrumental in the team to help us achieve the indicators and where there may be coding issues.

10. Whilst the Pharmacy Technician led the meeting, EVERYBODY contributed, and we checked and challenged our understanding of the indicators. We also identified areas for opportunity and improvement.

11. During the meeting, the Care Coordinator captured actions and areas for development.

12. The PCN Manager kept the meeting on track.

Actions resulting from the meeting

Please see below to give you an idea of some of the actions that came from the meeting.

1. To set up monthly pharmacy meetings, as a lot of the indicators were to be led by the Pharmacists and the Pharmacy Technician.

2. On a short-term basis, to hire an additional Pharmacy Technician as it was clear to see the expertise the current Pharmacy Technician brought to the network. We have someone in mind, so recruitment is quite straightforward.

3. To create a transparent process for call and recall for yearly reviews and for practices to consider who would be best suited to this task, e.g., Nurse/Pharmacist etc.

4. Review the Pharmacist rota to ensure time was allowed to support the IIF indicators.

Each task was allocated to a person, and the PCN Manager is the owner of the actions log.

The next meeting is scheduled for two weeks to keep up the momentum. From here, the review meeting will occur every month. The standing agenda items for the pharmacy review meeting will include;

1. Things working well

2. Progress against the actions log

3. An update of the IIF dashboard

4. Achievements outside of the IIF

5. Review of workload

6. Risks and issues

Every quarter, we will have a DES and IIF review which includes the PCN Board and the PCN Team. In between the quarterly meetings, the PCN Manager will contact the DES leads to ensure things remain on track.

I hope this helps!

I'm Tara; I am the founder of THC Primary Care, an award-winning healthcare consultancy specialising in Primary Care Network Management and the host of the Business of Healthcare Podcast. I have over 20 years of project management and business development experience across the private and public sectors, and I have supported over 50 PCNs by providing interim management, training and consultancy.

I have managed teams across multiple sites and countries; I have an MBA in Leadership and Management in Healthcare, I'm published in the London Journal of Primary Care, and I am the author of over 245 blogs. I have 3 children. My eldest has Asthma, my middle child has a kidney condition called Nephrotic SyndromeNephrotic Syndrome, and my youngest daughter has Type 1 Diabetes, so outside of work, healthcare plays a huge role in my life.