The relationships Scottish Government Health Department 14 Territorial NHS Boards 8 Special Health Boards.

The relationships

Scottish Government Health Department

14 Territorial NHS Boards 8 Special Health Boards

8 Special Health Boards Scottish Ambulance Service

NHS 24

The State Hospital

NHS Health Scotland

NHS Quality Improvement Scotland

NHS Waiting Times Scotland

NHS Education Scotland

NHS National Services Scotland

National Services Scotland

Health FacilitiesHealth Protection ISD NSDSNBTS

CLOCFSNISGNational ProcurementSHSCPSD

Practitioner Services

Document processing Data capture and verification Maintaining patient registration database Payment schedules Clinical Governance for Dental services

Our services are designed to enable contractors to be paid accurately and promptly for medicines and services supplied on behalf of the NHS.

How Primary Medical Services Payments

System (PMSPS)Works

Eduardo Zanré

PMSPS Overview

PMSPS

ISD

ATOS

QMAS

SPPA

CEDAR(BACS)

PSDTEST &

SUPPORT TEAM

GPs

GPASS EMISExeterVISION

ELINKS SERVER

ISD DATA WAREHOUSE

ISD PCD

CH

I Glo

bal S

um

(qu

ar terly)

CH

I QM

AS

(qu

arter ly)

CH

I Influ

enza (an

nu

al ly)

all i

nfor

mat

ion

prov

ided

mon

thly

GPs, Practices, Opt-outs(Ad Hoc)

GPCD Failure Emails

Polling Emails

Failure Emails

Su

pp

lier Fil es (A

d H

oc)

Pa ym

ent F

i le s (mo

nth

ly)

Practice Details (daily)Patient Count (quarterly)Opt Out / Opt In (daily)

ACHIEVEMENT AND ASPIRATION

ACKNOWLEDGEMENTS

Locum Supera

nn Files and R

eports

PARTNERS

Scotland Wide Payments

Global Sum

Superannuation

Seniority

Global Sum

Global Sum Fund The Scottish Allocation Factor (SAF) Factors and Weighting Data Required for Global Sum Calculations – Community Health Index (CHI) ISD File The Calculation Temporary Patient Adjustment Minimum Practice Income Guarantee >> Correction

Factor

Superannuation

Background - New Contract 1st April 04 - Tiering 1st April 08 TimelineEstimated Interim EarningsGP Annual Certificate (GAC)

Seniority

Seniority Payments are designed to reward experience, based on years of Reckonable Service and the current arrangements came into force from April 2003.

Reckonable Service

Calculation

Trish Morgan Primary Care Contracts Manager

• GMS Contract• DES• NES• LES

Contract type 2006/07 2007/08 2008/09 2009/10

NES 1 1 1 1

DES 9 6 10 9

LES 10 14 18 17

SESP - LES 0 2 2 1

 Totals 20 23 31 28

2005-2009 rolled out a total of 39 contracts

What does this mean?• Change in contract process• Activity• Resource• Time

PRESSURE• CHP• Practice Managers• PCCT• PSD• Finance

Primary Care Contracts Team

Doctors

Dentists

Opticians

Pharmacists

• General medical services • General pharmaceutical services• General Dental services• Ophthalmic services

ADMINISTRATION

• PCC Medical Team• Changes to Contract Process• Future proposals• Partnership working

Contracts • Contract Monitoring Group

Chair Norma Buschman• Enhanced Services Group

Chair Bob Liddell• Local Medical Council

Chair Neil MacRitchie

Primary Care ResourcesPrimary Care Resources

Bob Sivewright – Finance ManagerBob Sivewright – Finance Manager Jacqueline Gall – AccountantJacqueline Gall – Accountant Sheila Roberts – Resources ManagerSheila Roberts – Resources Manager Lorraine Grant – Assistant Lorraine Grant – Assistant

AccountantAccountant Elaine Leslie (Keith) – Assistant Elaine Leslie (Keith) – Assistant

AccountantAccountant

Enhanced ServicesEnhanced Services

Directed enhanced servicesDirected enhanced services

National enhanced servicesNational enhanced services

Local enhanced servicesLocal enhanced services

Directed Enhanced Directed Enhanced ServicesServices

Influenza, Pneumococcal & H1N1Influenza, Pneumococcal & H1N1

Minor surgery injections and Minor surgery injections and invasive proceduresinvasive procedures

Childhood immunisations and Childhood immunisations and preschool boosters including preschool boosters including Pneumococcal Child Vaccine (PCV)Pneumococcal Child Vaccine (PCV)

Directed Enhanced Directed Enhanced ServicesServices

OsteoporosisOsteoporosis – – Engagement, £100 for one year only. Achievement, Engagement, £100 for one year only. Achievement, £450 per 640 patients where min 80% interventions have been achieved£450 per 640 patients where min 80% interventions have been achieved

EthnicityEthnicity – – Lump Sum (A)Lump Sum (A)

Palliative CarePalliative Care - - Sliding scale up to £555 per practice with average list Sliding scale up to £555 per practice with average list of 1000 patients (Lump Sum)of 1000 patients (Lump Sum)

Management informationManagement information – – Part A 4p per registered patient or 16p Part A 4p per registered patient or 16p Parts A & B Parts A & B

Better WorkingBetter Working – – Approx. 56p per patient. Split between an Approx. 56p per patient. Split between an engagement fee of 70% of total with 30% balance payable on receipt of engagement fee of 70% of total with 30% balance payable on receipt of report (Lump Sum)report (Lump Sum)

Extended HoursExtended Hours – – GP, £2.95 per patient PA. & Nursing £0.74 per GP, £2.95 per patient PA. & Nursing £0.74 per patient PA. (Q)patient PA. (Q)

NESNES

INR Anti CoagulationINR Anti Coagulation - - £100 per £100 per treated patient (M)treated patient (M)

DMARDSDMARDS - - £100 per treated patient (M)£100 per treated patient (M)

IUCDIUCD (insertions and failed) - (insertions and failed) - £135 £135 per claim (M)per claim (M)

LESLES

Drugs MisuseDrugs Misuse – – Retainer £1000 PA & £360 per patient Retainer £1000 PA & £360 per patient PA (M)PA (M)

Care HomesCare Homes - - £98 per patient PA (Q)£98 per patient PA (Q)

Minor InjuryMinor Injury - - Retainer £600 PA & £10.80 per patient Retainer £600 PA & £10.80 per patient based on list size (M)based on list size (M)

Orthopaedics (Shire)Orthopaedics (Shire) - - £0.50 per registered patient £0.50 per registered patient PA (M)PA (M)

Dermatology (Shire)Dermatology (Shire) - - £0.50 per registered patient £0.50 per registered patient PA (M) PA (M)

Referred Minor SurgeryReferred Minor Surgery - - Varying fees across CHP Varying fees across CHP areas see individual contractsareas see individual contracts

LESLES Implanon - Implanon - £82.58 per procedure (M)£82.58 per procedure (M)

Ring shelf pessary - Ring shelf pessary - £75.00 removal and insertion, £25.00 £75.00 removal and insertion, £25.00 removal only (M)removal only (M)

Neo natal checks - Neo natal checks - £25 per valid check (M)£25 per valid check (M)

Violent & difficult patients -Violent & difficult patients - £2 - 4k per violent patient £2 - 4k per violent patient contract PAcontract PA

Diabetes - Diabetes - Payment based on notional costs for Medical, nursing Payment based on notional costs for Medical, nursing & admin time paid pro rata on % of patients in practice care. (M)& admin time paid pro rata on % of patients in practice care. (M)

Alcohol - Alcohol - £15 per BI made (one per annum per patient) (Q) £15 per BI made (one per annum per patient) (Q)

Retainer fee of between £200 – £800 PA based on list size.Retainer fee of between £200 – £800 PA based on list size.

Cardiac Failure - Cardiac Failure - £12 per annum per identified patient on £12 per annum per identified patient on register (Q)register (Q)

Board Administered FundsBoard Administered Funds

SenioritySeniority AssociatesAssociates Locum allowances, sickness, Locum allowances, sickness,

maternity, paternity and adoptionmaternity, paternity and adoption Career startCareer start Golden HelloGolden Hello Contingency FundContingency Fund

Premises reimbursementsPremises reimbursements

RentRent Domestic RatesDomestic Rates Water RatesWater Rates Trade Refuse CollectionTrade Refuse Collection Improvement GrantsImprovement Grants

Other paymentsOther payments

Miscellaneous payments funded Miscellaneous payments funded sourcesource

Periodic PaymentsPeriodic Payments HCH practice staffHCH practice staff Levy DeductionsLevy Deductions Local Authority PaymentsLocal Authority Payments Infectious DiseasesInfectious Diseases

WEBSITESWEBSITES

Show websiteShow website http://www.show.scot.nhs.uk/http://www.show.scot.nhs.uk/

publicationspublications Statement of Financial entitlementsStatement of Financial entitlements http://www.sehd.scot.nhs.uk/pca/PChttp://www.sehd.scot.nhs.uk/pca/PC

A2009(M)10.pdfA2009(M)10.pdf BMABMA http://www.bma.org.uk/http://www.bma.org.uk/

CONTRACT REVIEW CONTRACT REVIEW PROCESSPROCESS

CONRACT REVIEW PROCESSCONRACT REVIEW PROCESS

WORKING IN GROUPS WE WOULD LIKE YOU TO

REVIEW THE CONTRACT REVIEW PROCESS FROM A PRACTICE

PERSPECTIVE

TAKING INTO ACCOUNTTAKING INTO ACCOUNT

• WHAT IS BENEFICIAL FROM A PRACTICE POINT OF VIEW

• WHAT YOU WOULD LIKE TO SEE RETAINED IN THE REVIEW PROCESS

• WHAT IS NOT BENEFICIAL IN THE REVIEW PROCESS

• WHAT WOULD YOU LIKE TO SEE REMOVED

HOW CAN WE IMPROVE ON THE HOW CAN WE IMPROVE ON THE PROCESSPROCESS

• WHAT ADDITIONAL AREAS WOULD YOU LIKE TO SEE INCLUDED IN THE REVIEW PROCESS

• OTHER WAYS WE CAN IMPROVE ON THE PROCESS

• ADDITIONAL INFORMATION YOU AS A PRACTICE WOULD LIKE TO RECEIVE PRIOR TO OR AT A VISIT

AS A GROUPAS A GROUP

• TAKE THE NEXT 30 MINUTES TO DISCUSS THE QUESTIONS

• SELECT SOMEONE TO FEED BACK FROM YOUR GROUP

• IF YOU HAVE SUBSEQUENT SUGGESTIONS PLEASE EMAIL ME AT [email protected]