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GMS Contract changes 2019 highlights

4-Mar-19

New GMS contact changes

The GPC gave a local roadshow in Bristol on 28th February.  Information about the changes is coming from various sources.  The main thing to grasp is that practices need to band themselves into geographically-based Primary Care Networks of between 30,000 and 50,000 patients.  The timescale for doing this is very tight.  By 29th March a template network agreement and Network contract will be issued jointly by NHS England and GPC England. Practices then have until 15th May to submit their registration information to the CCG.  The CCG has to confirm network coverage by 31st May and the network contract goes live on 1st July.  If you have any questions or face any difficulties in complying with this timetable then the LMC stands ready to help you.

GP Contract Funding

Please see below table with updated GP contract funding figures for 2019/20 following the contract agreement a few weeks ago.

Figure

2018/19

2019/20

Value of QOF point

£179.26

£187.74

Global Sum price per weighted patient

£  88.96

£  89.88

Out of Hours adjustment

4.87%

4.82%


Participation payment

£105m total

Annual payment per weighted patient*

£1.761

*This figure will be paid in instalments direct to practices, upon signing up the PCN DES.

These figures have been agreed between NHS England and GPC England - the BMA GP contract webpage will be updated shortly with these figures. These figures include the recycling of MPIG and Seniority into global sum, and therefore the figures represent greater than the 1.4% contact uplift noted in the contract agreement document.

In addition to the above, a one-off payment to cover indemnity inflation arising in 2018/19 is planned for March 2019 - this figure is still being calculated and information will be provided soon.

The above figures are in addition to the other financial agreements, for example uplift S7a V&I programmes, all funding via the network, and the delivery of the state-backed indemnity scheme, and do not include payments for any uplift in employer pensions contributions which will be funded separately.

Changes to QOF in 2019/20

Twenty-eight indicators, worth 175 points in total, will be retired from April 2019.  For details see Annex A (pages 60 to 63) of the full agreement at this link:

https://www.bma.org.uk/-/media/files/pdfs/collective%20voice/committees/gpc/gpc%20england/investment-and-evolution-five-year-framework.pdf?la=en

These retired points will be taken up by:

  • Fifteen new indicators, totalling 101 points (see pages 63 to 65 of the same document).
  • The new Quality Improvement domain consisting of 'end of life care' and 'prescribing safely' modules, each worth 37 points, which are detailed at Annex B of the full agreement (page 67 onwards).

Communication with District Nurses

4-Mar-19
The new DN Contact Hubs (now all in place) were established to avoid any patient safety governance issues caused by failed communication between GPs and DNs. This was a recommendation following a review by the Adult Safeguarding Board. Note that communication to district nurses does not always have to be through the Hub. 

  • Initial communication about a patient that needs to be put on the DN caseload should go through the Hub.
  • The Hub provides a reliable back-up means of communication between the GP and the DN for patients currently on the caseload.
  • However, for those patients on the DN caseload we would hope the GP could feel free to phone the DN direct. 
  • Depending on the urgency of the case the local Hub can be contacted by email, with a request for confirmation of receipt, or by phone. 

It would help the Hub to assign the right DN if the GP could give guidance on the urgency of the case, both as to time and the reasons for the referral.

Cyber attacks

1-Feb-19
Practices doubtless have excellent firewalls and other protection for the computing equipment they regularly use.  One possible weakness to the practice system as a whole is if there are spare items of equipment which are brought into use without checking that the protections are mounted on them too.  Be aware of the risk.

Data Security & Protection Toolkit

1-Feb-19
If your practice still needs to register on the Data Security and Protection Toolkit (DSPT), please log in or register here (www.dsptoolkit.nhs.uk). You will need your practice organisation code and email address.  

All organisations which have access to NHS patient information must provide assurance that they are practising good information governance and use the DSPT to evidence this through the publication of annual assessments. DSPT submission deadline is 31 March 2019, so practices need to start working through the toolkit as soon as possible.

If you would like help with the new DSPT, you can register for a training webinar at: www.dsptoolkit.nhs.uk/News/40 . We have been advised that there are Q&As at the end of the webinars. The forthcoming dates are:

       Wednesday 16 January 2019 (12.30-13.30)       Dial in Details

       https://hscic.webex.com/hscic/j.php?MTID=m145d48c0b8052e7870b8a7833d8fbd0d

       Thursday 14 February 2019 (12.30-13.30)         Dial In Details

       https://hscic.webex.com/hscic/j.php?MTID=mf4cecebb0a6f35cf784aa98ea793d0d7

You can also find presentation slides from a GP webex and a recording of latest webinar Data Security and Protection Toolkit Introductory guide at www.dsptoolkit.nhs.uk/News/10

Additional help is available on https://www.dsptoolkit.nhs.uk/Help . Requests for support can be made by email to exeter.helpdesk@nhs.net or telephone 0300 3034034.

The Care Provider Alliance has also produced specific Care Provider Guidance and Templates on their website (https://www.careprovideralliance.org.uk/information-governance.html) to complement the Toolkit. This resource contains a good overview of the Toolkit and other useful information.

Salaried/Locum GP; Hadwen Medical Practice, Gloucester

18-Dec-18
Salaried/Locum GP - Maternity Cover up to 8 Sessions per Week

Would you like to join our friendly, successful and supportive Practice?

Applicants are sought for a Salaried GP position at Hadwen Medical Practice for a 12 months fixed term maternity cover contract with a nominal start date of 1st March 2019. We will also consider the locum model of employment if applicants prefer this type of flexibility.

We are a training practice with 8 partners and 5 salaried doctors, and pride ourselves on excellent monthly in-house CPD meetings. We offer a supportive, well-managed working environment and a happy and functional practice team and have received an extremely positive CQC inspection. We have also have recently completed a major redevelopment of our Glevum surgery that will help us to meet the future clinical needs of our patient population.

The Practice is situated in a growing city with excellent transport links, 6 local grammar schools, sporting and recreational facilities and beautiful countryside nearby.

Please contact our Management Partner, Ian Robertson, at Ian.Robertson1@nhs.net for further information or to arrange an informal visit.

To apply for the position please forward your CV and covering letter by email to the Management Partner.

New national data opt-out

3-Jul-18
NHS Digital has announced the introduction of a new national data opt-out and conversion of Type 2 objections, enabling patients to make a choice about whether their data can be used for research and planning purposes. The Type 2 objection means that a patient's confidential information should not be shared for purposes beyond their individual care. NHS Digital has written to practices to explain that they will automatically be converting patients' existing Type 2 objections to the new optout from 25 May 2018. Every patient aged 13 or over with a Type 2 objection recorded will receive a personal letter after 29 May, explaining the change, and a handout explaining the national data optout. Patients will not have to take any action and this will not affect the way that their information is used.    Practices will not be able to see the national data opt-out in the patient's electronic record as they will be held on the NHS Spine and will not be updated in GP systems. The Type 2 objection codes will still be available in GP systems after 25 May 2018 but must not be used from the 1 October 2018 as NHS Digital will no longer continue to process and convert them.  



Some patients may also have a Type 1 objection registered on their electronic record, which should continue to be respected. The Type 1 objection prevents the sharing of a patient's personal confidential information held by the GP practice for purposes beyond the patient's individual care. It remains the responsibility of the practice to ensure these are applied where relevant, except for General Practice Extraction Service (GPES) collections where the Type 1 objection will be applied automatically unless instructed to the contrary by Direction.   NHS Digital will be sending practices a pack of patient communication materials to help explain the changes and have developed a checklist of actions that practices might want to take, available here

e-RS: Switch-off of paper referrals

5-Jun-18
The target is now to reach 100% of GP referrals to first consultant-led outpatient appointments being made by e-RS no later than 1st October.  The LMC is content that the current use of e-RS (well over 90% of referrals) is sufficient to take the next step: a hard launch on 4th June.  After that date:



  • If, for any reason, a two-week-wait (2ww) referral is made by 'paper' (i.e. post, email, fax or phone) it will still be accepted, but the practice will be reminded that it could have been, and should have been, submitted by e-RS.
  • All other 'paper' referrals will be scanned and returned (by email) to the practice.  However, for three days the Trust will send daily emails about each one to the practice to check that they have resubmitted the referral by e-RS.  It will be up to the practice to confirm this to the Trust.
  • If after three days of those reminder emails the Trust still has no confirmation that the referral has been resubmitted by e-RS they will phone the practice before dropping the referral.  (It is not expected to reach that stage often.)
  • 'Urgent' referrals will automatically take priority over Routine referrals when appointments are being allocated, but there will also be provision for GPs to explain to consultants just how urgent they feel the referral is.

If you need to contact GHFT about a referral or patient, then contact the Central Booking Office - 0300 422 4599 - ghn-tr.centralbooking@nhs.net

To escalate issues, please use the following email address ghn-tr.accessdelays@nhs.net. This can be used only after the main routes of contact have been pursued and is for escalation items only; the Central Booking Office should always be contacted in the first instance.


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