Contract meeting for Sessional GPs June 2013

1. Contract meeting for Sessional GPsJune 2013 Dr Patricia Moultrie Glasgow LMC Sessional GP Representative Glasgow LMC

2. What is a Local Medical Committee? • elected committee of local GPs • represents GPs in Glasgow and Clyde • provides support and advice to GPs and practices Glasgow LMC

3. Funding • voluntary levy paid by all GPs, cost dependent upon list size • levy also finances the LMC’s contribution to the GP Defence Fund for national GP representation Glasgow LMC

4. Helping individual GPs • The LMC provides help and advice to assist GPs steer through the NHS. Such help is available on all matters relevant to general practice including: • Workload issues • Coping with change • GPs’ remuneration • GPs’ terms and conditions of service • Complaints • Premises/Partnership affairs • Any disputes which may occur • Sick doctors and those with performance problems Glasgow LMC

5. National debate and policy setting • Scottish and National Conferences of LMCs. Proposals from individual LMCs across the country are debated alongside those from the GPC. • The outcome of the debate determines the framework for the profession’s negotiations at both national and local levels. Glasgow LMC

6. GlasgowLMCandSessionalGPs • relationship • communication • representation • information • common interest Glasgow LMC

7. Contact Glasgow LMC • Dr Patricia Moultrie, Sessional GP Representative on pamoultrie@doctors.org.uk • Mrs Mary Fingland, Office Secretary on mary.fingland@glasgow-lmc.co.uk Glasgow LMC

8. Components of the Current GMS Contract Alastair Taylor Vice Chair Glasgow LMC Glasgow LMC

9. Funding Streams • Global Sum & MPIG • Quality and Outcomes Framework • Enhanced Services • Health Board - administered funds, including seniority • Premises • IM&T • Dispensing/personal administration of drugs Glasgow LMC

10. Global Sum • Calculated (Scottish Allocation Formula) to reflect: • The age and sex structure of the practice population (demography) • The additional need of the practice population (morbidity and deprivation) • The rurality and remoteness of the practice population • Creates a “Weighted List” to allocate the Global Sum Glasgow LMC

11. Global Sum Covers: • Essential Services • Additional Services • Staff Costs • Locum Reimbursements (for appraisal, career development and protected time) • The cost of GPs “employers superannuation” contributions for those funding allocations mapped across from the old red book contract.

12. Global Sum Deductions • For opting out e.g • Out of Hours 6.0% • Cervical Screening 1.1% Glasgow LMC

13. MPIG • Minimum Practice Income Guarantee • MPIG = Global Sum via formula+ Correction Factor • Correction factor = How much greater Global Sum Equivalent was than Calculated Global Sum Glasgow LMC

14. Quality Outcomes Framework QOF • Clinical Areas: • Atrial fibrillation, CHD, Heart failure, Hypertension, Peripheral arterial disease, Stroke and TIA, Diabetes mellitus, Hypothyroidism, Asthma, COPD, Dementia, Depression, Mental health, Cancer, Chronic kidney disease, Epilepsy, Learning disabilities, Osteoporosis, Rheumatoid arthritis, Palliative care, Cardiovascular disease - primary prevention, Obesity, Smoking, Cervical screening, Child health surveillance, Maternity, Sexual health Glasgow LMC

15. QOF (2) • Quality and productivity (QP) e.g. Referrals/ACP • Patient experience (PE) – 10 min appointments • Quality improvement (QI) – Trigger Tools/Patient Safety Questionnaire • Medicines management (MM) • Public health (PH) “Blood pressure” in over 40s Glasgow LMC

16. Enhanced Services • Directed (DES) • e.g. Childhood Immunisation, Flu jabs, Extended Hours • Local (LES) • E.g. CDM Glasgow LMC

17. Other Streams • Seniority: • starts after 2 years in post (6 yrs reckonable) • Premises • Cost Rent/Notional Rent • IM&T • Hardware and Software supplied – to specification • Dispensing • Won’t discuss here

18. The End Any Questions for the Panel at the End? Glasgow LMC

19. Contributing to practices’ contract work2013/14Dr John Ip Glasgow LMC

20. Importance of QOF • Significant funding for practices • Increased levels of work • More indicators • Higher thresholds Glasgow LMC

21. 2013 QOF Changes- RA • New Rheumatoid Arthritis domain • 4 indicators total of 18 points Glasgow LMC

22. 2013 QOF Changes- RA • Register (1 point) • Annual face to face Review (5 points) • Assess CVD Risk 30-85 years using ASSIGN (7 points) • Assess Fracture Risk 50-91 years using FRAX (5 points) Glasgow LMC

23. 2013 QOF Changes • Diabetes • Annual dietician review (3) • New patients- referral to Structure Learning Programme (11) • ED screening, advice (4) & treatment (6) • COPD • O2 Sat for Grade 3 and above (5) Glasgow LMC

24. 2013 QOF Changes • Depression • Biopsychosocialassessment at time of new diagnosis • 10-35 day review after diagnosis • Primary Prevention CVD • SCOT-PASQ for patients with HT diagnose after 1 April 2009 Glasgow LMC

25. Glasgow LMC

26. 2013 QOF Changes • All 15 month targets are now 12 months • Some thresholds for full achievement increased ( 5-10% increase) Glasgow LMC

27. Other Contract Work • Medicines Management • ScriptSwitch • Anticipatory Care Pathways & eKIS • Polypharmacy Reviews Glasgow LMC

28. Tips for EMIS Glasgow LMC

29. Correct Coding • Using Templates • Values e.g. BP, BMI • Medication Reviews • Smoking Status & advice Glasgow LMC

30. Reviews of Patient • LARC advice for Contraceptives • Dementia review Glasgow LMC

31. Population Manager • The Pop up boxes • What do they mean? Glasgow LMC

32. Other Tips • Searching in consultations • Audit trail for medicines Glasgow LMC