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Quality premium ‘will be up to £5 per head’

The Government has revealed CCGs will be given up to £5 per head of population if they achieve their targets, and may be able to share this among practices 'with no caveats' at all.

The Government's national managing director of commissioning development Dame Barbara Hakin said the money could be given to practices with ‘no caveats at all', or be distributed to them by their CCG ‘with certain caveats.'

The quality premium payment will be paid alongside a management allowance of £25 per patient. 

Speaking in an NHS Commissioning Board webinar earlier this month, Dame Barbara said that ‘up to £5 a head' will be dependent on CCGs meeting Commissioning Outcomes Framework (COF) targets and may be also dependent on achieving ‘financial balance'.

Final regulations, expected before Parliament in October, will set out which targets CCGs will need to deliver on to achieve the premium, which is fiercely opposed by the GPC. The regulations will also stipulate whether the premium will be linked to financial performance, and how the money will be distributed to member practices.

Dame Barbara said: ‘One could imagine that that money could be handed out to practices with no caveats at all, or it could be for the CCG to use in a different way, or it could be for the CCG to hand out to practices, but with certain caveats.'

NICE has recommended COF indicators across eight areas, including mortality for cancer and respiratory disease, patient experience of GP out-of-hours services and emergency admissions.

The quality premium will be brought in from April 2014, but Dame Barbara said CCGs would not realistically receive the money until the second quarter of 2014/15, as they would need to be assessed to determine whether they qualify for payment.

Dr Chaand Nagpaul said the £5 per patient should be added to the CCG's management allowances, rather than being paid to practices.
He said: 'We would have wanted CCGs to have £30, based on PCTs getting £30-35 [per patient] and the greater pressure that will be put on CCGs. We don't think it should be a premium or an add on.
'It just seems at odds with what the Government is trying to achieve. We believe that it will divert attention away from local priorities to central priorities. We have an ongoing dialogue with the National Commissioning Board and we will continue to argue that this money should be handed out to CCGs.'


CORRECTION: Please note a previous version of this article linking the quality premium to the management allowance that CCGs receive was incorrect. We have been informed by the NHS Commissioning Board that these payments remain completely separate. We apologise for any confusion caused by this.