The following support article summarises the requirements for the Network DES contract for 2021/22 and offers guidance around how Ardens can help you achieve these requirements. Please see NHS England guidance here.


Enhanced Health in Care Homes

For a PCN's patients who are living in the PCN Aligned Care Home(s), its suggested clinicians to deliver a weekly 'home round'. Please see pages 46 and 47 of the NHS England guidance for further information.


Ardens have provided searches to help practices identify patients within care homes, using the correct coding as required by the PCN DES.


To locate the searches, navigate to the Population Reporting module > Ardens Searches >  5.3 Ardens National Cntract Reports >PCN DES > Care Home folder.



The Care home data quality search folder identifies patients who have a 'care home' code in their record which is not recognised by the PCN DES business rules. You may wish to re-code these with 'Lives in residential home' or 'Lives in nursing home' (or 'living temporarily in care home') as these are the recognised codes.



There are PCN DES Care Home searches in the same suite of searches, within the 'Network Extract: Management Information searches:



To support practices with capturing  consistent ward round data for care home patients, the Ardens Care Home template is available, please see further details of this template here along with other supporting templates.



Early Cancer Diagnosis 

Our understanding of the service specification is that practices should work together to achieve the QOF QI Early Cancer diagnosis. 


The Quality Improvement for Early Cancer Diagnosis requires practices to improve participation in the national cancer screening programme, and also improve referral and safety-netting practices for patients suspected of having cancer.


Ardens have a number of resources to support these requirements.


The Ardens Cancer screening searches (which can be located in the Population Reporting module > Ardens Searches > 5.6 Ardens Cancer Searches > Cancer screening searches folder), identifies uptake for bowel and breast screening for those patients eligible. 



The Cervical screening uptake and call/recall folder contains searches to identify eligible patients that are yet to have cervical screening and due either a 1st, 2nd or 3rd invitation.


The Ardens Fast Track Safety Netting Tools allows practices to keep track of patients referred for a 2WW fast track referral. The tools include alerts to warn clinicians if a patient is yet to be seen within 3 weeks. Further information of the Ardens Fast Track Safety Netting tools can be found here.



To monitor achievement of cancer activity and identifying work that still needs to be done relating to PCN DES. Access the Population Reporting module > Ardens Searches > 5.3 Ardens National Cntract Reports > PCN DES > Cancer folder.


The Clinical Activity folder (once run) will report on the diagnosis, referral and screening activity recorded for this fiscal year.


The Work to do folder identifies work to be done. This is mainly patients that have not had screening advice recorded in this fiscal year. The practice also have the option to narrow down to specific groups of patients, such as Learning Disability, Transgender and BAME. 


To complete the work to do, access the patients displaying in the Population Included tab, check if a patient has been given advice and code appropriately.


The Ardens Cancer Template includes a Cancer Care Review page to complete the review for the patient.



For further information on the different Ardens cancer resources, please see the following support article


Additional Roles Reimbursement Scheme (ARRS)

Each PCN may employ Allied Health Professionals to work with GP Practices. 


Social Prescribers and Clinical Pharmacists may wish to use the Ardens Social Prescribing and Health Coaching Template to record activity. This template can be located in the Ardens > Other templates > Social folder



Physiotherapists may wish to use the Ardens Musculoskeletal Template to record activity. This template can be located in the Ardens > Other Templates > Musculoskeletal folder.


Ardens has created a suite of searches to help practices and PCNs to monitor the activity of the Allied Health Professionals. To access the searches, navigate to the Population Reporting module > Ardens Searches > 5.3 Ardens National Cntract Reports >  PCN DES > Network Extract: Management information folder.


The folder contains searches broken down by role:



Run the searches individually or by entire folder to view the results.


Structured Medication Reviews (SMR)

PCNs should identify specific groups of patients who need a SMR. To support practices to identify target populations, Ardens have created a suite of searches.


To access the searches, navigate to the Population Reporting module > Ardens Searches > 5.3 Ardens National Cntract Reports > PCN DES > SMR folder.


The Clinical Activity folder outlines the SMR activity done in this fiscal year, broken down by the types of review recorded.


The Register folder will provide practices with a list of target population for SMR. 


The SMR - target populations folder breaks down the target population by groups (care home residents, patients recorded as having a fall or admission in last 6 months, housebound, medication associated with errors, severe frailty patients and those patients on 10 repeats or more.


The SMR Data quality search folder identifies patients who have had a 'medication review' since 1st October 2020 and have more than one element of SMR done and may need a SMR coded added to their record. 


The Work to do folder identifies work to be done and patients requiring a structured medication review. Click on the Population Included tab to identify the patients. Please note - the Ardens Structured Medication Review includes standardise coding of this activity.



To standardise coding of this activity, Ardens have provided a Structured Medication Review template and Pharmacist Review Template, both can be searched for via the Run Template option in the consultation screen.


Please see the following support article, for further information on the Structure Medication Review template - click here.


Investment Impact Fund (IIF)

The Network DES Investment and Impact Fund has been revised for 2021/22 with fewer new indicators than was planned and increase in funding. All of last year's indicators have been replaced.


There are four indicators worth 178 points in the Prevention and Tackling Health Inequalities domain. Three of these are linked to seasonal influenza vaccination, and one is linked to Learning Disability Health Checks. 

  • VI-01: The % of patients aged 65 or over who received a seasonal influenza vaccination between 1 Sep and 31 Mar (40 points with minimum 80% achievement).
  • VI-02: The % of patients aged 18-64 years and in a clinical at-risk group who received a seasonal influenza vaccination between 1 Sep and 31 Mar (88 points with minimum 57% achievement).
  • VI-03: The % of children aged 2-3 who received a seasonal influenza vaccination between 1 Sep and 31 Mar (14 points with minimum 45% achievement).
  • HI-01: The % of patients on the Learning Disability register aged 14 or over who received an annual Learning Disability Health Check and have a completed Health Action Plan (36 points with minimum 49% achievement).


There are two indicators worth 47 points in the Providing High Quality Care domain. These are linked to social prescribing and mapping appointment types.


  • PC-01: Percentage of patients referred to social prescribing (20 points).
  • ACC-01: Confirmation that, by 30 June 2021, all practices in the PCN have mapped all active appointment slot types to the new set of national appointment categories, and are complying with the August 2020 guidance on recording of appointments (27 points).


Ardens has created a suite of IIF searches to support practices monitor achievement and a summary of work still to do. To access the searches, navigate to the Population Reporting module > Ardens Searches > 5.3 Ardens National Cntract Reports > PCN DES > IIF folder.



Further sub-folders are available for each indicator, outlining what has been achieved and identify incorrect coding errors to action.


For further information on the Ardens resources to support Learning Disability activity, please see the following support article.


For further information on the Ardens resources to support managing the flu activity, please see the following support article


If you require any further assistance on the process above, please contact Ardens support on: suport-emis@ardens.org.uk