The BMA has released the full details on the 2013/14 GP contract for Scotland, including the breakdown of substantial QOF concessions the Scottish GPC has negotiated in a clear departure from the UK Government’s proposed contract deal.
It will see 37 points moved from the organisational domain in order to implement the clinical QOF changes from the NICE 2013/14 QOF menu that the parties have agreed to implement.
The organisational domain will be scrapped also in Scotland, but instead of the points going into new enhanced services work for dementia, IT and risk-profiling, as is proposed by the UK Government, the points will be reused within QOF.
A further 17 points will be transferred to a new public health domain, 33 points will remain for patient experience but no longer within the organisational domain, while 23 points will be transferred to a new medicines management domain.
The SGPC has agreed to implement the majority of NICE QOF proposals for 2013/14 but has reached concessions on the proposals branded ‘unworkable’ by the UK GPC, with some of them not being introduced at all while others will see agreements for wider exception reporting. The indicators that are not being implemented frees up 11 points which the SGPC said will be used to introduce key elements of the patient safety programme in general practice.
Scottish GPs will also avoid the full extent of QOF threshold hikes proposed in the UK consultation, where some may be raised to 100%, as no Scottish thresholds are to be set above 90%.
As previously reported by Pulse, the Scottish Government has also agreed to move 77 points that are exiting organisational QOF and put that money back into the global sum. The BMA has now outlined the details around the important concession, saying that for each practice the sum will be calculated as an average of the previous three years achievement for those points.
Scotland has also agreed to defer any decision on a removal of MPIG, although the SGPC has agreed to examine what the correction factor payments mean for Scotland and variation in funding between practices.
BMA Scotland said: ‘This move reinforces the emphasis on professionalism with these standards as core expectations with associated core funding – practices will still be required to provide the work associated with these indicators but monitoring will be consistent with existing post-payment verification for the core elements of the contract.’
In a letter to Scottish GPs, Dr Alan McDevitt said: ‘I last wrote to you on 25 October 2013. At that time UK negotiations on changes to the GMS contract for 2013/14 had come to an abrupt halt following a deicision by the Department of Health to consult on imposition. The Scottish Government had communicated with me in more positive terms recognising that negotiations between GPC and NHS Employers had not met the needs or expectations of either side.’
‘We entered into complex and challenging discussions over the course of one month. I am pleased to tell you that we have managed to reach an agreement that has been supported by the SGPC and the Health Secretary. This agreement represents a short period of intense negotiations and I wish to pay tribute here to the Scottish Government’s lead negotiator and his team for a principled and positive approach.’
‘We believe we have gone a long way to achieving the aims of our negotiations.’
The SGPC thinks the deal will:
· Deliver clinical benefits to patients
· Focus primary care resources on the most vulnerable patients in the community
· Provide greater stability of funding for GP practices
· Address some GP practice workload concerns
· Support and value the work of the wider Primary Health Care Team based around the GP practices
Key elements of the deal include:
· A substantial portion of points’ achievement from the QOF organisational domain transferred to the core funding element of the contract
· Anticipatory Care Planning activity to replace QP QOF indicators on A&E and emergency pathways
· Agreement in Scotland that variation in funding between GP practices will be explored
· Substantial amelioration of the workload implications of the introduction of NICE changes to clinical QOF