NHS managers will provide funding of £500k to practices to survey vulnerable patients as part of the unplanned admissions DES if they decide to go ahead with the survey element of the service.
NHS England today published the service specification for the avoiding unplanned admissions DES, and confirmed it was unsure whether to continue with the survey element of the DES, as revealed by Pulse this week.
However, it said that funding of £500,000 would be available to practices ‘in the event the survey does go ahead’.
When the GPC and the Government agreed to continue the DES as part of the GP contract agreement, the Government successfully pushed for a new element where practices would distribute a survey devised by NHS England to the 2% of their patients identified as being the most vulnerable.
The GPC had argued that the survey would be too work intensive and too costly for practices to undertake and last week, speaking at the Pulse Live conference, GPC deputy chair Dr Richard Vautrey said NHS England had listened to the argument.
The DES specification confirmed that the survey may indeed be scrapped as it will be subject to a ‘feasibility study’ that is ‘currently under way’. It also confirmed that if it does go ahead, GP practices will be provided with all printed material and postage.
The specification said: ‘Subject to the outcome of a feasibility study (currently under way), GP practices may be required to survey patients on the case management register using a nationally developed and provided survey questionnaire.
‘The GP practice would be provided with all printed materials and postage (if applicable) and would only be required to identify the correct patients within the identified 2% cohort and to either send it out or give it to them (exact method to be confirmed).
‘Final survey details would be subject to the outcome of a feasibility study. In the event the survey does go ahead, then funding of £500,000 will be available to support GP practices in implementing the survey.’
The service specification also said commissioners should invite GP practices to participate in the DES, which is worth £162m in total, before 30 April and practices wishing to participate will be required to sign up no later than 30 June.
The payments will be based on a maximum of £2.87 per registered patient and based on three components: an upfront payment of 46%; a mid-year payment of 27% subject to achieving all of the DES requirements during the first half of the year; and an end-of-year payment of 27% subject to achieving all of the requirements during the second half of the year.
As previously reported the main changes to the renewed DES, aside from the survey, were all focused on reducing the heavy bureaucracy associated with it in the first year, including: the reporting template being cut by half; care plans for patients who die or move away will now count within the 2%; and patients who received a care plan during 2014/15 will have to be reviewed, but will not need a completely new care plan.
Avoiding unplanned admissions DES 2015/16 requirements
- Maintaining the register at a minimum of 2% for the first and second half of the year (i.e. 1 April 2015 to 30 September 2015 and 1 October 2015 to 31 March 2016). Achievement of this component will be determined by GP practices having a minimum of 1.8% of patients on the register on the last date of the six months in question, as a proportion of the list size taken on the first date of the six-month period.
- Identifying the named accountable GP and care co-ordinator (if applicable) and informing any new patients added to case management register.
- Developing personalised care plans with any new patients on the case management register or, for all patients already on the register, undertaking at least one care review in the last 12 months. The development or review of care plans will be undertaken with the patient and where applicable, their carer.
- Implementing or continuing a system for same-day telephone consultations for patients on the case management register with urgent enquires.
- Specifying and using the practice’s ex-directory or by-pass telephone number.
- Reviewing and improving the hospital discharge process for patients on the case management register, including attempting to contact these patients, by an appropriate member of the practice or community staff, in a timely manner to ensure co-ordination and delivery of care.
- Undertaking regular practices reviews of emergency admissions and A&E attendances of all their registered patients in care and nursing homes, as well as undertaking monthly reviews of all unplanned admissions and readmissions and A&E attendances of patients on the case management register.
- Participating in the survey (if it goes ahead).
Source: NHS England