The Department of Health has released the final version of its planned changes to the GP contract in England next month – and has made few amendments to the proposals it first consulted on in December.
Ministers will press ahead with sweeping changes to the QOF, raising thresholds, removing £164m in funding from the organisational domain and introducing new indicators recommended by NICE. They will also introduce four new directed enhanced services, covering the assessment of patients with dementia, improving care management for frail older people, telehealth and online patient access, and phase out the Minimum Price Income Guarantee over seven years from April 2014.
The Government also announced that all practices will receive a 1.47% uplift overall, paid through global sum equivalents, including a 0.15% uplift to cover extra charges incurred through paying locums’ employers superannuation charges.
The DH has made a handful of concessions on the changes after input from five stakeholder organisations during the consultation, and said the NHS Commissioning Board had made some alterations to the proposed new DESs to ‘ensure they are implemented in a phased way’.
In 2013/14, the DES to promote earlier diagnosis of people with dementia will focus on patients who have a higher risk of dementia because of their clinical condition (eg vascular disease or a long-term neurological condition).
Meanwhile, the scheme to promote greater use of online services will focus on booking appointments online and ordering repeat prescriptions online, and the scheme to help monitor the health of people with long term conditions will focus on preparatory work this year while processes and protocols for management across a range of long term conditions are developed.
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The DH said more information on the DESs will come shortly from the NHS Commissioning Board.
But the only changes it has made to its wideranging proposals for changing the QOF are deferring implementation of the two NICE-recommended indicators for referral to cardiac and pulmonary rehabilitation services until 2014/15 and phasing in thresholds for two of the indicators on physical activity, as well as giving a greater proportion of QOF funding to these and the new indicator on blood pressure control to recognise the initial impact on practice workload.
Health secretary Jeremy Hunt said: ‘Improving care for patients has always been my priority. The GP contract needs to change to make sure the excellent care enjoyed by some patients is more consistent across the country. Providing better treatment for people with long term conditions helps save lives and I know GPs will rise to the challenge to make sure standards of care in this country are world class and continuously striving to improve.’
‘We have listened to GPs and stakeholders and made some changes to our proposals to reflect these views and now feel we are in the right place to go forward. I am committed to ensuring that we improve quality of life for people with long term conditions – and I want GPs to lead this change from within their own practices.’
The DH announced last week that practices will receive a 1.32% increase in current funding, less than the 1.5% it had initially offered and disregarding the DDRB’s recommended 2.29% uplift.
The DH added that GP practices would ‘also be able to earn extra funds’ through the £10m investment in two new immunisation programmes for shingles and rotavirus.