1 / 56

Enhanced Services Roll-out process

Learn about the enhanced services roll-out process in primary care, the key providers, contracts, referrals, and the impact of NHS reforms on primary care contractors.

hanita
Download Presentation

Enhanced Services Roll-out process

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Enhanced Services Roll-out process Lynette DawsHead of Primary Care Development and Service IntegrationMarch 2014

  2. Background • Securing Excellence in Commissioning in Primary Care – published June 2012 • Transfer of enhanced services • CCGs • NHS England • Local Authority

  3. Procurement • Any qualified provider (AQP) – any provider who is able to provide a specific service and meets the required minimum standards • Competitive tender (CT) – different providers are invited to tender for a contract • Single action tender (SAT) – contracts awarded directly without competition (code of conduct / conflicts of interest)

  4. Any qualified provider (AQP) • Services: • Ear irrigation • ECGs • H pylori breath testing • Phlebotomy • Treatment room • Awarded through a Standard NHS contract

  5. Single action tender (SAT) • Services: • Anti coagulation monitoring • Asylum seekers • Chronic disease monitoring/shared care (x4) • Homeless • Neo natal checks • Primary support to care homes • PSA • Awarded through a Standard NHS contract

  6. What happens now? • Provider event held 18 February 2014 • All services commence 1 April 2014 (except Phlebotomy) • AQP – awarded following tender process • Single tender actions – communication to practices for continuation • Guide produced and communicated

  7. Primary care services - making a referral • GPs that are not on the AQP provider list: • Referrals via CAS • Patient contacts CAS and offered choice of provider • Referral sent to chosen provider (nhs.net) • Outcome communicated to referring GP

  8. Primary care services - making a referral • GPs that are on the AQP provider list: • Offered choice and choice recorded • If appointments can’t be provided patient contacts CAS (except if patient chooses to wait for an appointment)

  9. Clinical assessment service (CAS) • Offer patient choice • Turn around times • 24 hours • 48 hours • 4 days • Send referral to chosen provider • Chosen provider contacts patient to arrange an appointment • It is the patients responsibility to contact the CAS

  10. Key contacts • Susanne Croll – contract officer • Joanne Milner – CAS manager • Andy Taylor – finance

  11. Area Team Update Jonathan Rycroft, Keith Mann, Joe Lunn Primary Care March 2014

  12. This session …… • Changes to primary care commissioning • What this means for primary care contractors • Our approach to quality improvement • Strategic challenges and opportunities for primary care • Questions and answers NHS | Primary Care Presentation | March 2014

  13. Reforms: Understanding the new NHS NHS | Primary Care Presentation | March 2014

  14. Reforms: Derbyshire and Nottinghamshire • D&N Area Team • 10 CCGs in Area • 4 Local Authorities • 4 HW Boards • c 2m population • c 1200 primary care providers NHS | Primary Care Presentation | March 2014

  15. Reforms: Area Team functions • Assuring the effectiveness of CCG commissioning • Direct commissioning: • Primary Care (AT) • Public Health (AT) • Health and Justice (EM) • Armed forces Health (M&E) • Specialised Services (LL AT lead) NHS | Primary Care Presentation | March 2014

  16. Reforms: PC team responsibilities • Completing a safe transition – legacy issues? • Commissioning and assuring: • A core offer of high quality primary care services • Continuous improvement in primary care quality and patient outcomes • Facilitating longer term transformation of primary care in line with practice, CCG, AT and national vision NHS | Primary Care Presentation | March 2014

  17. Reforms: PC team for Nottinghamshire Nottinghamshire GP & Pharmacy Team 156 GP Contracts, 219 Pharmacy Contracts, 6 CCGs Keith Mann: Contract Manager Kerrie Woods & Liz Gundel: Assistant Contracts Manager Rachael Owen (0.5 wte): Assistant Contracts Manager (Estates) Richard Hobbs: Primary Care Support Mark Yates: Primary Care Support Jayne Bouch: Primary Care Support Denise Ellis: Administrator NHS | Primary Care Presentation | March 2014

  18. Reforms: What does all this mean for PC? • Less close relationship than with PCTs • National policies / single operating models with less local flexibility. E.g. Xmas opening, mergers • New requirements e.g. e-declaration, CQRS • More commissioners and procurement processes (e.g. enhanced services) • Mapping investments to benefits • Knowing who to call! NHS | Primary Care Presentation | March 2014

  19. Reforms: What does all this mean for PC? • Contractual approach in 2014/15 • GMS – contract changes • QOF pts reduced by 341 to core funding and enhanced services • Seniority to be removed over 6 years – funds back to core funding • New DES on unplanned admissions • Three DESs removed from 2013/14 • New IT requirements, including ability for patients to book online and access their Summary Care Record • All patients 75 and over assigned a named accountable GP to ensure coordinated care NHS | Primary Care Presentation | March 2014

  20. Reforms: What does all this mean for PC? • PMS / APMS – as predecessor PCT arrangements • PMS baseline exercise to inform national review • GP Premises • New national premise development process expected • New landlords - NHS PS, CHP • Triennial rent reviews NHS | Presentation to [XXXX Company] | [January 2014]

  21. Reforms: Quality improvement • Identifying potential concerns: • Performance against the GP HLIS / GPOS • CQC compliance • Fitness to practice concerns • Incidents, complaints, GP patient survey • AT improvement actions: • Collaborative approach with CCGs • Contractual action • Fitness to practice process NHS | Primary Care Presentation | March 2014

  22. CCG integral to process Informed by CCG Regular review of intelligence Learning / best practice shared Triangulation with other intelligence / stakeholders (e.g. CCGs / CQC) Primary Care Quality and Performance AT PC QAG logs outcome of actions AT contract lead proposes next steps & urgency AT PC QAG considers, approves and logs next steps AT and / or CCG review success of actions AT / CCG liaise to agree approach / actions AT and / or CCG lead agreed actions (improvement or contractual) NHS | Primary Care Presentation | March 2014

  23. Strategic context: Call to action • Today: • The NHS treats 1,000,000 people every 36 hours • Between 1948 and 2010, life expectancy in England for men increased by 13 years to 79 • 88% of patients in the UK described the quality of care they received as excellent or very good

  24. Strategic context: Call to action • Demand and costs are increasing • Ageing population, growing co-morbidities and increasing patient expectation • Innovation and technological advances increasing costs • Quality challenges • Recent unacceptable quality failures • Unwarranted variation in quality and outcomes • Some pockets of unacceptable performance NHS | Primary Care Presentation | March 2014

  25. Strategic context: Call to action • A Call to Action, requires each CCG and NHS England to engage with the public, health and wellbeing boards and other stakeholders to explain the challenges ahead, and to then develop a 5 year commissioning plan. • Improving General Practice A Call to Action aims to stimulate a specific debate in local communities – amongst general practice, area teams, CCGs, health and wellbeing boards and other community partners – as to how best to develop general practice services NHS | Presentation to [XXXX Company] | [January 2014]

  26. But over the last 10 years…50% increase in GP consultations35% increase in emergency care admissions65% increase in secondary care episodes for >75’s • 50% increase in GP consultations • 35% increase in emergency care admissions • 65% increase in secondary care episodes for >75 • Combination of factors – • Demographic change • Poorly joined up services between primary, secondary and social care • Technical advance • Economic decline NHS | Presentation to [XXXX Company] | [January 2014]

  27. Consequences • Hospitals under greater pressure • Too many older people or people with a long term condition admitted to Hospital • Poorly coordinated services • People not supported to remain independent • Too many people being admitted too early to long term care • Unsuitable model of care (primary care) NHS | Presentation to [XXXX Company] | [January 2014]

  28. Tight and growing economic constraints

  29. Strategic context: Primary care strategy • There is a need to create an environment that enables general practice to play a much stronger role, as part of a more integrated system of out-of-hospital care • CCGs are drafting local primary care strategies in response to these challenges • Local pilots and PM’s challenge fund to trial innovative working NHS | Primary Care Presentation | March 2014

  30. This session …… • Changes to primary care commissioning • What this means for primary care contractors • Our approach to quality improvement • Strategic challenges and opportunities for primary care • Questions and answers NHS | Primary Care Presentation | March 2014

  31. Nottingham City CouncilLocally Commissioned Public Health Services(formerly Local Enhanced Services)PLT Session Practice Managers • Speakers: • Quality and Commissioning: Kaj Ghattaora • Public Health: Carl Neal, Sarah Bolstridge • Crime and Drugs Partnership: Clare Fox

  32. Health and Social Care Act. • Public Health transferred to the local authority 1st April 2013 • Locally Enhanced Services transferred from PCT to: • Nottingham City Council (Public Health & CDP) • CCG • NHS England • Contracts transferred to the respective 3 organisations • 2013/14 Interim Arrangements: LA & CCG working together re payments • New Name: Locally Commissioned Public Health Services (LCPHS) • Local Authority developing Contract and Performance team

  33. Locally Commissioned Public Health Services • General Practice • IUCDs • Sub Dermal Implants • Asymptomatic Chlamydia Screening • Asymptomatic STI Screening • NHS Health Checks • Alcohol • Substance Misuse (CDP)

  34. Locally Commissioned Public Health Services • Policy Leads: • Crime and Drugs Partnership (CDP) • Alcohol • GPwSI • Public Health • Sexual Health • NHS Health Checks

  35. Locally Commissioned Public Health Services • Procurement and Contracts 2014-15 • Public Health – managed by Quality and Commissioning • Drug and Alcohol Services – managed by Crime and Drugs Partnership

  36. Public Health- Procurement & Contract Arrangements • New 1 year Contracts for 2014/15 on LA T&C • One Contract per practice with service specifications attached for each LCPHS (Sexual Health & Health Checks) • Contracts to go out by first week of March • Please return asap to LA Contracts Team • Audits and monitoring

  37. Sexual Health Services

  38. Sexual Health - Claims Process • All claims for 2014/15 NCC, not the CCG. • New contracts: a new quarterly monitoring claim form, completed on a quarterly basis • New contract also includes a supplier detail form for practices to complete and return asap • For 2014/15: please submit your 2014/15 claims tolphcs@nottinghamcity.gov.ukby the 10th day of the following month • Public Health Contracts Team will be available to answer your query. Named individual to be identified • Payments Levels to be maintained for 2014/15

  39. Sexual HealthNew Business • We are happy to receive enquiries regarding new business • There is an application to complete and a process to follow for practices to sign up for new business • Payments structure will be issued by Nottingham City Council to practices quarterly • For Sexual Health: please send any enquiries to lphcs@nottinghamcity.gov.uk

  40. Sexual HealthAccreditation • As Commissioners: - evidence for practitioners who provide LARC and STI services for quality assurance and patient safety. • GMC registration (or NMC for Nurses) • DBS • Letters of Competencies for IUT / Sub-Dermal • Recertification of LoC • Sexual health related CPD training in last 5 years (for Nurses) • Evidence of minimum number of procedures • Completion of BASHH STIF3 course- including date and level. • 2014/15 Claims cannot be processed until we receive evidence.

  41. Sexual HealthTraining • FSRH recently announced changes to its General Training Programme (FSRH Diploma and Letters of Competence). Includes: • Introduction of an on-line knowledge assessment (eKA) for health professional to qualify for a FSRH Diploma or Letter of Competence • Current holders of the DFSRH wishing to take a LoC will not be required to do this • The opening up of the FSRH Diploma to nurses, linked to full nurse diplomate membership of the Faculty (NDRSRH). • The opening up of the Letters of Competence in IUT and SDI to nurses and doctors without having to first obtain the Faculty diploma. • http://www.fsrh.org/pages/TempPage1.asp

  42. Sexual HealthTraining • Chlamydia: training or review meetings for may be arranged with the CSO as required • Chlamydia: Health care professionals - update, maintain & develop their capabilities according to their own identified learning needs. • STIs: professionals required to attend a BASHH STIF course and training sessions provided by NUH (GUM) • LARC:LoC IUT3 from FSRH / LoC SDI5 from FSRH (doctors) • LARC: RCN accreditation (nurses) • NUH training sessions within their service specification – inc. FSRH and BASHH accredited postgraduate training • PMs ?? Your understanding of training needs??

  43. Sexual Health LCPHS– the future • Commissioners are looking at how we commission LCPHS from April 2015 onwards across the City and County

  44. NHS Health Checks

  45. NHS Health Checks: • Business as usual – standardised service specification to be used across City and County, and updated with national guidance • GP NHS Health Check software - purchased by LA from The Computer Room (TCR) for a further year • NHS Health Check clinical system templates being updated with support from NHIS (to be issued to practices shortly) • Accreditation – appropriately trained staff as per national workforce competences guidance

  46. NHS Health Checks: • Revised payment structure to reflect change of emphasis from invitations to uptake, to increase effectiveness of the programme

  47. Health Checks - Payments • Data submitted via The Computer Room NHS Health Check software will continue to be used to calculate payments • Payments will be issued by Nottingham City Council to practices quarterly

  48. NHS Health Checks – the future • Commissioners are looking at awarding long term contracts from April 2015 across the City and County • Procurement options are being explored and there will be a consultation in the summer.

  49. Crime and Drugs Partnership

More Related