How much will practices receive for the DES?
The DES will be worth £2.87 per patient on a practice’s list. It total, it will be worth £20,400 for the average practice.
How will practices receive the payments?
An upfront payment of 45% of the total – around £9,000 to the average practice – will be paid at the end of the first month following the month practices sign up: ie, at the end of May for any practices signing up this month.
There will be a further four payments; one at the beginning of each quarter (20% at the beginning of Q1, 10% at the beginning of Q3 and Q4), and one at the end of the year.
What will practices be paid to do?
• Practices must use a risk-profiling tool to identify a minimum of 2% of adult patients (and any children) who are at high risk of admission to hospital for their ‘case-management register’.
• Practices need to make sure those patients initially placed on the register have a named GP and personalised care plan in place by the end of June. Thereafter any patients added onto the register should be informed of their GP within three weeks and have a care plan in place within one month.
• Practices will be expected to undertake monthly reviews of their risk register to check whether they need to take any action to prevent unplanned admissions – for example on the basis of whether patients requiring multidisciplinary team input are receiving it, and whether the practice is receiving appropriate feedback from the district nurse team.
• Practices must also offer same-day telephone consultations for patients on their at-risk register and provide a dedicated phone number to other health professionals such as A&E, ambulance service and care home staff, to support decisions on admission or transfer to hospital – within one hour in some cases.
How much extra work will it be?
It will involve a bit more paperwork but the GPC says the DES contains many elements practices already carry out as part of the current risk-profiling enhanced service and Quality and Productivity domain in the QOF.
Will payments be contingent on a reduction in unplanned admissions?
No. The DES will be monitored through practices completing a national reporting template.