‘Named GP’ for all patients
What are the changes?
NHS Employers announced that the new contract for England will require practices to assign a ‘named, accountable GP’ for all patients, including children, who will take lead responsibility for the ‘co-ordination of all appropriate services required under the contract’. This follows this year’s introduction of a ‘named GP’ for all elderly patients.
What will GPs have to do?
Practices will be able to inform patients who their named GP is at the ‘next appropriate interaction’ in the year April 2015 to March 2016, so there is no need to write to patients. By 31 March 2016, practices must state on their website that all patients now have a named GP.
What does the GPC say?
‘We believe the notion of all patients having a named GP endorses the important personal link between GPs and patients, promoting continuity of care and reinforcing the value of our long-term relationship with patients.’
Workload added: 2/4
QOF
What are the changes?
Following a massive cut in QOF points last year, there will be no new indicators or higher thresholds introduced, only ‘minor’ changes to existing indicators.
These are: the amendment of atrial fibrillation indicators as recommended by NICE with additional points to reflect the workload; an increase in the number of points for dementia care planning and annual reviews; the redistribution of 36 points and the retirement of a number of indicators (for CKD and coronary heart disease).
The GPC has confirmed that it has successfully rejected NICE’s proposals for a ‘bundled’ diabetes indicator. Unlike last year, the GPC has also managed to negotiate adjustment in the value of a QOF point to reflect population growth, meaning that the value of the QOF will remain the same this year.
What will GPs have to do?
Much the same as this year.
What does the GPC say?
‘These important, clinically appropriate changes to the QOF recognise the rising practice workload involved in ensuring patients with dementia get the best possible care. The reforms to the CKD domain will reduce box-ticking.’
Workload added: 1/4
Enhanced services
What are the changes?
The unplanned admissions DES will be renewed for another year, but reporting obligations will be halved and patients on the 2% register who die or leave the practice will not have to be replaced. Payments will be split into three instead of five. Aspects of the patient participation enhanced service and the alcohol enhanced service will become contractual obligations, with funding reallocated to the global sum.
What will GPs have to do?
DES achievement in preventing unplanned admissions will be reported twice a year instead of quarterly, on a simpler reporting template. Patients with care plans from the previous year can remain on the 2% register, but GPs will have to give them at least one care review during the year. Practices will be obliged to retain a patient participation group and GPs will continue to identify newly registered patients aged 16 or over who drink alcohol at increased or higher risk levels, and offer interventions.
What does the GPC say?
‘We have achieved a reduced burden on GP practices. These are substantial, and the Government is not in the habit of reversing changes just introduced.’
Workload added: None
Online access
What are the changes?
There are two new requirements being introduced in April 2015 – increasing the information that patients can access in their record and improving online appointment booking. The GPC has also agreed to work with NHS England to ensure that 60% of practices use the Electronic Prescription Service by 31 March 2016, that practices offer patients ‘secure electronic communication’, and that the new ‘e-referrals’ replacement for Choose and Book is used for 80% of referrals by 31 March 2016.
What will GPs have to do?
During 2015/16, and by March 2016, patients who make an ‘active application’ to the practice should be given access to detailed records comprising coded information. Free text will not be accessible and GPs will be able to withhold coded information if this is in the patient’s interests or where there is reference to a third party.
What does the GPC say?
‘We negotiated that free text would not have to be accessible. This will answer legitimate concerns regarding remote access to accounts of consultations.’
Workload added: 3/4
Maternity and paternity cover
What are the changes?
Reimbursement for locum cover for GPs on maternity and paternity leave will become an automatic right. In a letter to area teams, NHS England said the change would see all practices entitled to ‘reimbursement of the actual cost of locum cover for maternity, paternity or adoption leave of £1,113.74 for the first two weeks and £1,734.18 thereafter, or the actual costs, whichever is the lower’. This will cover external locums and – for the first time – extra hours provided by existing GPs in the practice.
What will GPs have to do?
Apply for funding from area teams.
What does the GPC say?
‘For 10 years we were unable to change the Government’s position that maternity and paternity payments were discretionary and could only be made to locums.’
Workload added: None
Publication of GP earnings
What are the changes?
Publishing GP earnings was in this year’s contract deal, but the deadline has been extended after wrangles over what should be published. The idea is that practices will publish mean earnings for GPs in their practice, including partners, salaried doctors and long-term locums. But NHS England said this was an ‘interim solution’ before it pushes ahead with ‘publishing individual GP net earnings in 2016/17’.
What will GPs have to do?
Practices must publish on their websites (by 31 March 2016) the mean earnings for all GPs working in the practice for longer than six months for the financial year 2014/15. NHS England and the GPC are agreeing a ‘dataset’ with more information about what earnings will be included but we already know that income from premises and employee superannuation will be exempt. There are further suggestions that GPs will have to publish their individual earnings from 2016/17, although the GPC says nothing has yet been agreed (see main article).
What does the GPC say?
‘It will put an end to the exaggerated earnings figures being published annually by the Health and Social Care Information Centre. This will be done by GP practices, with their accountants.’
Workload added: 2/4
Out-of-hours opt-in
What are the changes?
A new reporting requirement for GP practices who have not opted out of out-of-hours provision will allow CCGs to check the provision against the National Quality Requirements or any updated requirements.
What will GPs have to do?
GP practices that are opted in to provide out-of-hours care will have to provide CCGs with regular information.
Workload added: 4/4
Other contract changes
Armed forces registration
The GMS regulations will be amended to allow for armed forces personnel to register with a GP practice for longer than three months and up to a maximum of two years.
PMS reviews
NHS England has committed to reinvest funding taken out of PMS into local GP services.
MPIG
Where a practice has opted out of providing out-of-hours services, a deduction is made from its global sum (historically 6%). Just as last year’s agreement on QOF and enhanced service funding moved money into the global sum, correction factor money that is reinvested in the global sum will not be subject to the out-of-hours deduction.
GP premises
The GPC has agreed with NHS England to establish a working group to explore a strategy for the development of GP premises and primary care estate.
Workforce
NHS England has agreed to work with the GPC to explore timely solutions to workforce issues, specifically: the retainer and returner scheme; the flexible careers scheme; and recruitment problems affecting specific areas (such as remote and rural areas).
