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In full: 2014/15 Welsh GP contract deal

The changes to the contract for 2014/15 include:

  • The number of QOF points will be reduced by 300 points from 969 points to 669 points.
  • 270 points will be released from the Clinical and Public Health domain through the retirement of indicators or the extension of reporting indicator timescales in relation to those indicators which have been considered to be overly prescriptive or duplicated elsewhere within QOF or have been considered to be sufficiently embedded in clinical practice or which will be addressed through a more holistic approach to certain health conditions. This will reduce unnecessary patient testing and unnecessary frequency of patient recall and recording
  • 33 points will be released through the retirement of the Patient Experience domain. This will to enable GPs to adopt flexibility in appointment setting based on clinical need and practice population.
  • 41 points will be released from the Organisational domain through the retirement of indicators considered to be sufficiently embedded as good practice.
  • 44 points (from the 344 points identified to be released as outlined above) will be transferred to a new Local Service Development domain which will replace the existing Quality and Productivity domain.
  • Commencing 2015/16, MPIG payments, totalling approximately £14m, will be redistributed on a formula weighted needs basis, equally, over a 7 year period.  In order to protect those practices most at financial risk, income losses (i.e. the reduction in income following MPIG payments being redistributed on a formula weighted needs basis) will be capped at 15% of Global Sum. It is estimated that approximately £1.8m will be retained permanently (as a Practice Support Payment) by those GP practices deemed at highest financial risk.  It is estimated that approximately 17% of practices will benefit from the Practice Support Payments.  It is estimated that approximately 50% of practices, primarily those practices located in areas of high deprivation, will benefit from redistribution. 
  • A small number of QOF lower payment thresholds will be increased to incentivise those practices who currently do not achieve QOF lower payment thresholds to improve QOF achievement.
  • The existing QOF domain will be replaced by a new Local Service Development domain worth 160 points. 
  • As part of a three-year development programme, this framework will enable practices to strengthen their ability to operate as a cluster / locality network. The aims of this work are to improve the coordination of care, to improve the integration of health and social care, and to improve collaborative working with local communities and networks to reduce inequalities in health.
  • Practices will be required to agree a GP Practice Cluster Network Plan.  The practice cluster network plan will address the following key areas: 
  • Access arrangements: benchmarking access arrangements (including capacity and demand analysis); exploration of adjuvants to access and user experience.
  • Actions to foster greater integration of the delivery of health and social care.
  • How new approaches in the delivery of primary care might aid service delivery  (e.g. new technologies, developing clinical roles, multi-disciplinary teams)
  • How practices can facilitate support for ambulance services in relation to care homes and Emergency Departments.          
  • Practices will also be required to develop and agree a Cluster Network Annual Report.
  • Practices will be required to participate in three national care pathways covering the early detection of cancer, end of life care and the frail elderly. These national care pathways, which will have a high impact on reducing, where appropriate and in the best interest of the patient, accident and emergency admissions and unscheduled care admissions. A national approach will enable both GP clusters and Local Health Boards to benchmark within and across localities as well as across Wales. It is anticipated that this work will also foster the development of wider skills within general practice.
  • Practices will be required to complete the Clinical Governance Practice Self Assessment tool which is designed to encourage practices to reflect and assess the governance systems they have in place in order to facilitate and demonstrate safe and effective clinical practice.

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