Abstract
Background Primary Care Networks (PCNs) were introduced to improve and standardise primary care delivery, with pay-for-performance (P4P) schemes like the Investment and Impact Fund (IIF) aiming to support high quality of care being delivered. While previous research has examined the relationship between deprivation and performance in other P4P schemes in primary care, like QOF, the impact of deprivation on IIF attainment has not been previously researched.
Aim To investigate the relationship between socioeconomic deprivation and IIF attainment by PCNs in England.
Method A Retrospective study of PCNs across England during the 2022/23 fiscal year. Data were collected for 1095 PCNs, with deprivation scores being obtained from the Index of Multiple Deprivation (IMD) and IIF attainment data from NHS Digital. A multivariate regression analysis was conducted to explore the association between deprivation quintiles and IIF points, adjusting for confounders including PCN characteristics, socioeconomic factors and disease prevalence.
Results PCNs in less deprived areas consistently outperformed those in more deprived areas, with a 39.32-point gap between the least and most deprived quintiles, equating to a shortfall of £7864 in funding. After adjusting for confounders, PCN deprivation remained significantly associated with lower point attainment, particularly in flu vaccination rates for children, where the disparity was greatest.
Conclusion There is inequality in IIF attainment by socioeconomic deprivation in England, even after accounting for PCN characteristics and disease prevalence. Further research and policy interventions may be needed to address this disparity and ensure equitable primary care quality across deprivation levels.
