Primary care trusts should save at least £300m on their general medical services budgets next year, after new terms for the GP contract were announced by NHS Employers and the British Medical Association today (Tuesday December 20).
NHS Employers lead negotiator Bradford South and West PCT chief executive Dr Barbara Hakin said PCTs should be able to save at least £1m each in the next financial year after the two sides agreed to maintain current prices attached to the quality and outcomes framework. The QOF financially rewards GPs for achieving defined standards of care and services.
‘What is good in this for PCTs is we have driven a lot of efficiency out of this contract,’ Dr Hakin told HSJ. ‘The very fact that there is no inflationary uplift whatsoever will be very helpful. The average uplift that PCTs have on their unified allocation for
2006-07 is nine per cent across England, and that includes money for GMS and PMS, and we believe that even if we assume that the GPs deliver on absolutely everything, assuming maximum costs we believe that this will cost a maximum four per cent uplift,’ she said.
Dr Hakin added that agreement to find ‘efficiencies’ had been reached because there was a ‘general recognition’ that there was a need to ‘rebalance’ the over-spend on forecast costs for GMS over the last three years.
She added that the ‘majority’ of PCTs should save a lot more, as they would have already allocated money to practice based commissioning and choose and book – which have become new designated enhanced services (DES) with incentives attached in the new 2006-07 contract.
PbC, choose and book and implementation of IT systems to allow transfer of patient records and monitoring have all become DES services with funding attached if a practice fulfils certain objectives within each area.
For choose and book, GPs will receive about 50p per patient for offering choice, and a further 50p for booking that choice.
Meanwhile, practices will receive £1 per patient for agreeing to put together a plan for commissioning for their list populations, then a further £1 per patient for demonstrating they have reduced the number of patients going into secondary care in locally agreed clinical areas.
Dr Hakin told HSJ that if PCTs and practices work well together on the practice based commissioning incentives, it should be ‘at worst cost neutral‘ to PCTs because their secondary care bill should be reduced.
Meanwhile the access DES has been amended so GPs must demonstrate patients can book advanced appointments, provide full telephone access and allow patients to book with the doctor of their choice as well as provide appointments within 48 hours to qualify for this target payment.
Seven new clinical and one new administration areas have been added to the QOF, while a few including points for good handwriting and efficient note filing have been removed.
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