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NEW GMS CONTRACT

NEW GMS CONTRACT . Stephen Newell Linda Turner Susan Watts. WHEN? . COMMENCES 1.4.04. WHY DID GP’S VOTE YES? . No “Red Book” No Items of Service (IOS) No over 75 or 3 yearly checks No Staff reimbursement No Saturday mornings No out of hours (OOHs) – can opt out

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NEW GMS CONTRACT

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  1. NEW GMS CONTRACT Stephen Newell Linda Turner Susan Watts

  2. WHEN? COMMENCES 1.4.04

  3. WHY DID GP’S VOTE YES? • No “Red Book” • No Items of Service (IOS) • No over 75 or 3 yearly checks • No Staff reimbursement • No Saturday mornings • No out of hours (OOHs) – can opt out • No permission required for new partners

  4. SOME IMPROVEMENTS • Increased investment in primary care • Incremental payments for quality • Exception reporting for quality payments • 100% reimbursement of computer costs • Opt in to enhanced services • End of 24 hour responsibility • GP pensions • GP seniority payments

  5. SOME CONCERNS • Funding • Transition • IT • Lack of clarity

  6. CLINICAL SERVICES • Essential • Additional • Directed Enhanced • National Enhanced • Local Enhanced

  7. ESSENTIAL • Medical management of patients who are (or believe themselves to be) ill, health promotion advice and referral as appropriate – reflecting patient choice • General management of terminally ill patients • Management of chronic disease – in discussion with patient

  8. ADDITIONAL • SERVICES • Cervical screening • Contraceptive services • Vaccs and Imms • CHS • Maternity Services • Minor Surgery

  9. OPT OUT • Can opt out of additional services but will loose approximately 10% of global sum if you opt out of all additional services.

  10. DIRECTED ENHANCED • Access to GMS • Childhood Vaccs & Imms • Influenza Vaccs (over 65’s and at risk) • Quality Information Preparation (1st 2 years only) • Services to support staff dealing with violent patients • Enhanced minor surgery

  11. NATIONAL ENHANCED • Patients who are alcohol misusers • Anti coagulant monitoring • IUCD fittings • Specialised care for patients with depression • Patients suffering from drug misuse • Provision of immediate care and first response care

  12. Enhanced care of the homeless • Intra partum care • Minor injuries services • More specialised services for patients with MS • Provision of near-patient testing, etc etc.

  13. LOCAL ENHANCED • PCT will decide what is needed • Local terms and conditions • Developed in response to local needs, e.g. diabetic service

  14. OUT OF HOURS • COVERS 18.30 – 08.00 EVERY DAY • WEEKENDS • BANK HOLIDAYS • IF YOU OPT OUT YOU LOSE ABOUT 6% OF GLOBAL SUM

  15. 4 QUALITY DOMAINS • CLINICAL • ADDITIONAL SERVICES • ORGANISATIONAL • PATIENT EXPERIENCE • PLUS

  16. CONTRACTUAL & STATUTORY REQUIREMENTS

  17. CLINICAL • Asthma • Cancer • CHD (including LVD) • COPD • Diabetes • Epilepsy • Hypertension • Hypothyroidism • Mental Health • Stroke or TIA

  18. Additional Services • Cervical Screening • Child Health Surveillance • Contraceptive Services • Maternity Services

  19. EXCEPTIONS • Patients who refuse to attend on 3 occasions • New or recently diagnosed patients • If treatment is not clinically appropriate • Patient has refused (given informed dissent) • Patient cannot tolerate treatment • Patient already taking maximum medication • Patient has another condition that affects treatment

  20. ORGANISATIONAL • Records and information • Patient communication • Education and training • Practice management • Medicines management

  21. PATIENT EXPERIENCE • Length of consultation • Annual patient questionnaires

  22. CONTRACTUAL AND STATUTORY REQUIREMENTS • NO POINTS ATTACHED • NO CHOICE • MUST DO

  23. EXTRA PAYMENTS • Holistic Care payments • Encourages breadth of clinical care • Quality Practice payments • Encourages achievement across the whole range of indicators, not just clinical.

  24. ACCESS • Extra points • Maintaining access targets • Maintaining quality

  25. REPORTING • LARGELY BASED ON TRUST: • Data entry during consultation including telephone calls / consultations • Audit generated by normal work • Virtually no claims or paperwork • Annual report on computer • Annual visit from PCT to check report • Appeals process if disagree with PCT

  26. PATIENT FLOWS • Practice Area • Patient choice • Removals • Allocations

  27. SUMMARY There are: • 76 Clinical indicators • 10 standards for Additional Services • 56 Organisational indicators • 4 Patient Experience requirements • 26 Contractual and Statutory requirements

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