nGMS & Update 2006
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Dear LMC Colleague The final version of the Datasets and
Business Rules for the QuOF for next year has been approved. This includes
all the codes, and how they are applied. For each area there are two
documents - one for Read 4 byte codes, the other covers Read 5 byte, Clinical
Terms Version 3 (CTV3) and SNOMED-CT. This means that there are 42 separate documents
in total.
Otherwise individual documents in 'PDF' format (c.
100K each) can be downloaded from: http://tinyurl.com/hdzkk
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The attached guidance
supports PCTs and SHAs in securing similar benefits to those achieved through
the General Medical Services (GMS) contract for 2006/07, from local Personal
Medical Services and Alternative Provider Medical Services contracts. It is
essentially a companion document to recent guidance published by NHS Employers
and the BMA, Revisions to the GMS contract 2006/07: Delivering Investment in
General Practice. This guidance
will be underpinned by a direction from Secretary of State that will require
PCTs and SHAs to review local contracts and seek to constrain payments made
under these in line with the 2006/07 GMS contract. Local PDF Copy |
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Agreement on Changes to
the General Medical Services Contract Letter from David Colin-Thomι, National Clinical
Director for Primary Care 23 February 2006 |
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Revisions to the GMS contract for 2006-07 in England, stage 1 Agreement has been reached between the BMA and NHS Employers to develop the GMS national contract, following completion of the first part of a two-stage review. Guidance released 19 February - The changes will take effect from 1 April 2006. The revisions will deliver improved services for patients through a contract that is fair to the profession and provides good value for public money. This guidance supports the implementation of the changes to the nGMS contract, 2006-07, that will come into effect from 1 April 2006. A copy of the guidance will be mailed to the primary care leads in all Strategic Health Authorities, Primary Care Trusts, General Practices and Local Medical Committees in England, over the coming weeks and should arrive by early March Full Document (please note this is the 219 page full document) Annex 1 Quality and Outcomes Framework Annex 2 Summary of Changes to QOF indicators for 2006/7 by Domain and Indicator Set Annex 3 New directed enhanced services (DES) payments summary Annex 4 Access DES, specification Annex 5 Choice and booking DES, specification Annex 6 Towards Practice Based Commissioning DES, specification Annex 7 Information Management and Technology DES, specification including data accreditation standards Annex 8 Excessive or inappropriate prescribing guidance Annex 9 Managed Lists The new QOF areas and indicators Nine new areas - totalling 138 points - are being introduced to Quality and Outcomes Framework (QOF) for 2006-07. These areas are: dementia, depression, chronic kidney disease, atrial fibrillation, palliative care, mental health (new), two new disease registers (obesity and learning disability) and one new organisational indicator (recording patient ethnicity). The General Practitioners Council (GPC) has advised all practices to wait until they receive the relevant guidance before carrying out any preparatory work in readiness for implementation from April 2006. NHS Employers and the GPC will be issuing more detailed implementation guidance in late January 2006. GPC Guidance on QoF GPC Focus on the
Quality and Outcomes Framework 2006 - What Has Changed QoF Points
- Removal, Redistribution, Assignment - Appendix 1 Changes to
the text of Existing Indicators - Appendix 2 Formula Review (extract from NHS Employers - http://www.nhsemployers.org/primary/primary-702.cfm) Discussions between NHS Employers and the BMA's General Practitioners Committee (GPC) on the future of the GMS allocation formula have been on-going since the start of the year. As part of the two-stage process, it has been agreed that any changes to the formula will not be implemented until 2007/8 at the earliest. Negotiators have agreed a process for the review and have completed the first phase which involved initial assessment of all the factors in the existing formula and of factors which could be included in a revised formula. The team will undertake detailed practice-level modelling to enable the negotiators to understand the impact of a new formula at different population levels and for different types of practices. The negotiators will make recommendations to the main General Medical Services plenary. New GMS Q and A - Local Copy |
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GMS Standard Contract (Gateway reference number: 5698) Please note that following publication of the NHS (Primary Medical Services)(Miscellaneous Amendment) (No.2) Regulations 2005 (SI2005/3315) (effective from 6/1/06) the GMS standard contract has been redrafted. A revised standard GMS contract, together with a standard variation document for use with all existing GMS contracts, is available at - http://tinyurl.com/9nxvs
The GMS Contract Regulations have been amended with effect from 6 January 2006 by the National Health Service (Primary Medical Services)(Miscellaneous Amendments) (No.2) Regulations 2005 (SI 2005/3315). As a result the standard GMS contract has been re-drafted and is available below in both PDF and Word format. This document supercedes the earlier document which will be withdrawn in due course. The new document should be used for all new GMS contracts entered into by the PCT. PCTs are reminded that all existing GMS contracts require amendment as soon as possible after 6 January, and they should aim to complete the exercise by the end of the first week in February. To help PCTs we have agreed with the GPC a standard variation document that has the effect of varying , without the need for further consultation, all existing GMS contracts to give effect to the required changes. As with earlier amendments this document can only be used where the PCT and its GMS contractor hold contracts that adhere to the numbering scheme in the original standard GMS contract. The variation document should be completed with the contractors details etc and sent to the contractor together with a duplicate of the notice. The contractor should be asked to sign and date the duplicate before returning it to the PCT to signify that they have received the variation notice. PCTs will notice that the variation notice contains new clauses 323A-323I (with a footnote as to their use). These clauses are not replicated in the revised standard GMS contract (for use in respect of new contracts) as the clauses relate only to transitional provisions linked to contracts in place prior to 6 January 2006. |
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Agreement reached on changes to the national GMS Contract Changes to the national General Medical Services (GMS) contract announced today will be better for patients, fair to the profession and secure good value for tax payers' money. Agreement has been reached between the BMA and NHS Employers to develop the GMS national contract for 2006/07. The agreement includes:
Relevant Documentation:
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While every effort
has been made to duplicate items from the main www.devonlmc.org/Whats-hot.htm
web page, Unfortunately due to the sheer quantity
of information being released, not all the data may not be on this page
nGMS
Guidance
The following is an updated list of
addresses to the main nGMS documentation.
- the NHS (General Medical Services Contracts)
Regulations 2004 (SI 2004/291)
http://www.legislation.hmso.gov.uk/si/si2004/20040291.htm
- the GMS Transitional and Consequential Provisions
Order 2004 (SI 2004/433)
http://www.legislation.hmso.gov.uk/si/si2004/20040433.htm
- the Default Contract
http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/ModernisingPay/GPContracts/fs/en
- the GMS Standard Contract
http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/ModernisingPay/GPContracts/fs/en
- GPC - New GMS contract - Investing in General
Practice (Blue Books & Updates)
http://web.bma.org.uk/ap.nsf/Content/NewGMSContract
nGMS Implementation
Guidance CD Rom - link
Hard copies of Delivering Investment in General Practice, along with a CDROM containing this
document, the draft contract regulations, draft SFE and draft standard contract
are available through the DH Publications Orderline on 08701 555 455,
quoting the following reference numbers:
· Delivering Investment in
General Practice: 34235
· CDROM New General Medical Services Contract -
guidance documents: 34239
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GPC - Read Codes FAQs - January 2004 The
following Read Code FAQs have been developed in response to the Read Code
queries received by the GPC. The FAQs are divided into 2 sections. Questions
1- 16 are general Read Code queries and Questions 17-22 specifically focus on
Exception reporting. This document is intended as guidance and will be
updated on a regular basis. Local Copy |
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Sustaining Innovation through New PMS Arrangements
December 2003 Forward by RT HON John Hutton
- Minister of State for Health With over 40% of GPs in The Government has given a
commitment to deliver £8.1bn of investment in primary care. PMS contractors
will have equal opportunity to benefit from this additional investment as
part of a truly local contractual relationship with their PCT. This will have
a significant effect on services, with local clinicians and patients being
able to design approaches to care that reflect local needs, choices,
circumstances and value. By using PMS contracts, PCTs and local clinicians
can be free from central direction and develop new exciting and innovative solutions.
I believe that together local clinicians and patients will be able to
identify opportunities for specific service developments that would not be
evident at a national level. PMS arrangements are
already very flexible and I am committed to increasing that flexibility to
ensure mainstream PMS retains the attributes that attracted practices to it
in the first place. This means not unpicking existing contracts and
maintaining financial commitments where they are agreed. However, I do
believe that if parties wish to discuss developing a new contract as a result
of permanence then they should do so. This guidance has been
developed to assist you in taking PMS into a new permanent phase. It has been
developed with five underpinning principles of choice, equity and fairness,
value, decentralisation and sustaining innovation. The hope is that it will
help you make the most of a new and vibrant PMS alternative. It includes
information on new flexibilities such as out of hours arrangements,
approaches to managing quality developments and new innovations such as
Specialist PMS. Most of all it demonstrates our commitment to PMS. PMS has always been a
driver of innovation and I hope you will continue to see it as an opportunity
to explore different approaches. Most of all I fervently believe that
together PCTs, local clinicians and local people can use PMS to develop
flexible approaches to delivering primary care where and when it is needed
most.
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The
Department of Health has today published guidance on the implementation and
operation of the new GMS contract. This guidance will assist both PCTs and
practices when discussing contracts and has been agreed with the NHS
Confederation and the General Practitioners Committee of the BMA. The guidance
is not stand-alone documentation and must be read in conjunction with the
regulations, standard contract and Statement of Financial Entitlement. ·
Foreword, Contents and
Chapter 1. Executive Summary ·
Chapter 2. Flexible
Provision of Services ·
Chapter 3. Improving Quality ·
Chapter 4. Modernising
Infrastructure ·
Chapter 5. Financing Primary
Medical Services ·
Chapter 6. Contracting
Process ·
Annex A
- Evidence on disease prevalence across practices ·
Annex B
- Calculating Global Sum and MPIG Payments ·
Annex C
- Indicative Contractor Budget Spreadsheet ·
Annex D
- PCT Financial Reporting Arrangements ·
Annex E
- Protocol for Handling Local Implementation Issues ·
Annex F
- Partnerships and the Definition of the NHS Employee The
Department of Health has today published a guidance note to the standard
contract published on This
guidance will assist PCTs and practices when discussing their contracts and
has been agreed with the NHS Confederation and the General Practitioners
Committee of the BMA. The
Department of Health has today published a draft version of the Statement of
Financial Entitlements (SFE) which underpins the financial arrangement for
the new general medical services contract. This SFE has been agreed with the
NHS Confederation and the General Practitioners Committee of the BMA. This
has also been circulated to stakeholders and other interested bodies. These
links are all to the http://www.doh.gov.uk/gmscontract/implementation.htm web site
Further
guidance can be found at... http://web.bma.org.uk/ap.nsf/Content/__Hub+GPC+contract |
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SI - NHS England GMS Contract Regulations 2004 9
Dec 03 |
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The Department of Health in These set out the rules in The Department are also publishing
draft: ·
guidance ·
standard contract between the practice and the PCO ·
Statement of Financial Entitlements, which will set
out in detail the way in which payments will be calculated and made to
practices, including the arrangements for the Global Sum, Minimum Practice
Income Guarantee, quality payments, directed enhanced services and the out of
hours opt-out. Subject to the successful conclusion
of the negotiations, the Department aims to publish these remaining documents
by next Friday 19 December. All documents will be published on the
Department of Health website and we will ensure that these can be accessed
via a link from the BMA website. The Department will ensure that all
practices receive a paper copy of the guidance. These will be with practices
in January. The timetable in the other three
countries is different. Details of the progress in each of the four countries
is set out in annexes to the letter which can be found on the BMA website: www.bma.org.uk/gpcontract Once the draft documentation has been
published, practices will need to take some time to read it and then begin
discussions with their Primary Care Organisation about reaching provisional
agreements on their contracts. We will provide further information and
guidance for practices very shortly. Download the document as PDF
please note this is a 103 page document
Revised Link *** |
Determining
Aspiration Payments for 2004/2005
During
2004/05 a new national IT solution will be implemented to support payments
processes around the quality framework, including the extraction of data from
practice systems and the calculation of points. This application will support achievement
payments at the end of 2004/05, and both aspiration and achievement payments
in future years.
Guidance Note for Practices
Doc Guidance Note for PCTs Doc IAU
Cover Note - nGMS & PMS
Contract: Calculation of Aspiration
Payments for the Quality and Outcomes Framework Doc The Interim Aspiration Utility ExcelThe IAU is a simple Excel workbook, comprising 20
spreadsheets. Practices will be able
to enter aspirations against all of the quality and outcomes framework
indicators, and the IAU will calculate the practices aspiration payment for
2004/05 from the information entered.
Practices will simply enter a percentage aspiration or, as
appropriate, a Yes/No response against individual indicators.
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Implementing the New GMS Contract 19 November Joint letter to all GPs and Primary Care
Organisations from Dr John Chisholm, Chairman GPC GPC Proposal Protocol for Handling Local Implementation Issues
PDF Joint Implementation Letter |
Updated
- Di rected Enhanced Services & National
Enhanced Services Specification Top
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Directed Enhanced
Services: All files are posted as PDF 1.
Access to General Medical Services 3.
Influenza Immunisation for those in the 65 and
Over and Other At Risk Groups |
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National Enhanced
Services: 1.
Anti-Coagulation Monitoring 2.
Enhanced Care of the Homeless 4.
Intra-Uterine Contraceptive Device Fittings 6.
More Specialised Services for Patients with
Multiple Sclerosis 7.
More Specialised Sexual Health Services 8.
Patients who are Alcohol Misusers 9.
Patients Suffering from Drug Misuse 10.
Provision of Near-Patient Testing |
Ballot Results Top
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Message to the GPC, LMCs and to the profession from the GPC Chairman I am pleased to inform
you of the results of the ballot of all UK GPs, undertaken by Electoral
Reform Services |
GMS Contract - Read Codes Top
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GMS Contract - IMT - Quality and Outcomes Framework
Read Codes Following the special read code release by the NHS
IA to suppliers on 1 October to support the GMS contract both the logical
query specification and the associated business rules will now be reviewed.
The process of revising the specifications will be a continuous one after
each read code release. The revised specifications will be released no later
than the 12 November. This does not effect the published read codes and
exception codes. More Information - http://www.doh.gov.uk/gmscontract/infotech.htm or specification document - PDF |
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The above information is reproduced
from the DoH Web Site |
Problems with PDF follow
this Link
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Last Updated on Friday, 17 March 2006
By John Baker Email: jb@devonlmc.org