REVISION TO GP CONTRACTS

Details of the revision to G.P contract for 2014/15 have now been released and these are summarized below:-

Publications of GP earnings
All practices will publish GP NHS net earnings in 2015.

QOF

341 points from QOF will be retired in England.

NHS Employers said of these, 238 points will be reinvested into core GP funding.

The remaining 103 points will be reinvested elsewhere in the contract with 100 points used to fund the new Enhanced Service for Avoiding Unplanned Admissions and Proactive Case Management and 3 points to fund improvements to the Learning Disabilities ES.  

Planned changes in QOF thresholds from April 2014 will be deferred for one year.

Enhanced Service – avoiding unplanned admissions and proactive case management. 

The introduction of a new ES, for one year, aims to improve services for patients with complex health and care needs, who may be at high risk of unplanned admission to hospital, In particular, to:

•    Provide timely telephone access, via ex-directory or bypass number, to relevant providers to support decisions relating to hospital transfers or admissions, in order to reduce avoidable hospital admissions or A&E attendances.

•    Case manage vulnerable patients (both these with physical and mental health conditions) proactively through developing, sharing and regularly reviewing personalised care plans, including identifying a name accountable GP and care coordinator.

•    Improve access to telephone or, where required, consultation appointments for patients identified in this service. 

•    Review and improve the discharge process, sharing relevant information and whole system commissioning action points to help inform commissioning decisions.  
•    Undertake internal reviews of unplanned admissions/readmissions.

The ES will be funded using the funding from the QP scheme in QOF (100 points) and the funding from the discontinued Risk Profiling Enhanced Service (£42m).

Seniority

Seniority payments will cease on 31st March 2020.

In the meantime, those in receipt of payments on 31st March 2014 will continue to receive payments and progress as currently, but there will be no new entrants from 1st April 2014.

It is intended that there will be a 15% reduction in spend each year. Any money released will be reinvested in core funding. 

Named GP for patients aged 75 and over

As part of the commitment to more personalised care for more patients with long term conditions all patients aged 75 and over will have a named accountable GP. 

Quality of out of hours services 

GP practices who have opted out of Out of Hours services will have to monitor the quality of those services and report any concerns they may have. 

Friends and Family Test 

It will be contractual requirement for practices to undertake the Friends and Family Test from December 2014.

Choice of GP Practice

From October 2014, all GP patients will be able to register patients from outside their traditional practice boundary areas without any obligation to provide home visits for such patients. NHS England will be responsible for arranging in-hours urgent medical care when needed or near home patients who register with a practice away from home. 

Patients needing access to a practice clinician after assessment

Where a patient has been assessed as needing contact with a practice clinician, the practice will ensure that when the patients contacts the practice, a practice clinician will agree appropriate next steps having regard to the patient’s condition and circumstances. 

CQC Inspections 

When the CQC’s new inspection arrangements are introduced, practices will be required to display the inspection outcome in their waiting room(s) and on the practice website. 

Patients and information 

During 2014/15 all practices will:

•    Use the NHS number in all clinical correspondence 

•    Provide the ability for all patients to book appointments online 

•    Allow all patients to order repeat prescriptions online

•    Update the Summary Care Record daily 

•    Transfer patient records using GP2GP facility 

•    Allow patients to access online the data continued in their Summary Care Record

Enhanced Services 

•    The Patient Participation scheme will continue for another year with the requirement to carry out a local survey removed due to the introduction of the Friends and Family Test.

•    The Extended Hours Access scheme is extended for another year with a number of flexibilities included to allow practices to work together to provide the most appropriate service for their patients.

•    The Dementia, Alcohol and Learning Disabilities schemes will be extended for a further year with some changes made. 

It has been agreed that the Patient Online (£24m) and Remote Care monitoring (£12m) ES will cease on 31st March 2014 and the associated funding reinvested into core funding. 

GP pay and expenses

The GPC and NHS England will separately submit evidence to the Doctor’s and Dentist’s Review Body (DDRB) in relation to the 2014-15 uplift to the GMS Contract.

If you would like to discuss any of the points raised above, please contact our team on 01704 215450.