GMS Contract 2011-12
Negotiations between the GPC and NHS Employers have now concluded and agreement has been reached with the Health Departments in England, Scotland and Wales.
All GPs in the UK have been sent a letter which sets out the details of the agreement. The letter can also be found on the BMA website.
The agreement relates to the following areas of the contract:
- Practice Expenses
- The Extended Hours DES in England
- Certain QOF points, indicators & thresholds
- Clinical DESs
- A new Patient Participation DES in England
- New Quality & Productivity Indicators in the QOF
Practices will need to be particularly mindful of the changes to the Extended Hours DES in England, where from 1 April 2011 practice will have improved flexibilities in the delivery of extended hours, alongside reduced funding for this work.
QOF Guidance 2011-2012
The new GMS contract agreement contains a number of changes to the QOF. The revisions include the retirement of 12 indicators (CH5, CHD7, DM5, DM11, DM16, STR5, MH7, EP7, Information 4, Records 21, PE7 and PE8) releasing 92.5 points for re-allocation. This includes the removal of 58.5 QOF points attached to patient experience of fast access and advanced booking (PE7 & PE8), as measured by the national GP Patient Survey.
The freed-up points will be re-used to fund the implementation of new clinical indicators recommended by the National Institute for Health and Clinical Excellence (NICE) for epilepsy, learning disability and dementia, in addition to the implementation of NICE’s recommendation for changes to other existing indicators (CVD-PP, Diabetes, Mental Health and Depression) and 11 new organisational indicators for improving Quality and Productivity.
The Quality and Productivity indicators are aimed at securing a more effective use of NHS resources through improvements in the quality of primary care by rewarding more clinically and cost-efficient prescribing, reducing emergency admissions by providing care to patients through the use of alternative care pathways and reducing hospital outpatient referrals. These indicators have been agreed for 2011-2012 only, but may be extended for a second year if significant progress has been made in achieving productivity savings.
Please see the BMA website for a breakdown of indicator wording, points and thresholds.
Click on the highlighted link to view the BMA's Focus on: QOF payments (April 2011) document.
Clinical DESs
The alcohol, learning disabilities and osteoporosis DESs introduced in 2008-2009 will continue until 31 March 2012. The requirements of these three clinical DESs remain the same and the payment scheme will mirror the payment scheme at the same rate that applied for the period 1 April 2010 to 31 March 2011. The Ethnicity and First Language DES will no longer be available from 1 April 2011. This is because the ethnicity DES was intended as a two-year catch up to enable practices to record ethnicity and first language for patients already on their list. Following the third year extension for 2010/11 this will now cease. Click on the highlighted link for the revised clinical DES guidance.
Extended Hours DES
Under the new GP contract deal, GPC negotiators and NHS Employers have agreed to roll over the Extended Hours Access DES for one year, until 31 March 2012. The new deal reduces the payment per registered patients from £3.01 to £1.90, but introduces a number of flexibilities into the provision of extended hours, including:
- during extended opening hours appointments may be offered by any healthcare professional, rather than GPs only;
- the current restriction on concurrent working during extended opening hours will be removed;
- urgent as well as routine care patients can be seen;
- the minimum continuous period of extended opening will be reduced from one and a half hours to 30 minutes
The funding released through the reduction in extended hours payments – around £60 million in total – will be shifted to a new Patient Participation DES.