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GP Out-of-hours
services
Twenty-two
exemplar programmes for integration between NHS Direct and out-of-hours
providers started in November 2001. A further 12 will begin in
March/April 2002.
These sites
will allow NHS Direct and out-of-hours providers to build up experience
of developing integrated services and the benefits of partnership
working — in line with the Department of Health’s report
"Raising standards for patients — new partnerships in
out of hours care", published in October 2000 (www.doh.gov.uk/pricare/oohreport.htm).
Planning
guidance for PCTs was issued in November and is available at www.doh.gov.uk/pricare/implementoohplanguid.htm.
An ‘out of hours’ handbook, providing information on
best practice and contact details, is also planned. Regular out-of-hours
updates will be issued.
Two out-of-hours
planning workshops have been held to support PCTs with the development
of their three-year implementation plans, which are due by 28
February 2002. Both workshops have been well received. They were
organised by the department in partnership with NHS Alliance,
National Association of Primary Care and the National Association
of GP Co-operatives.
The department
is currently consulting with the GPC and other professional organisations
on the changes to regulations required to implement the out-of-hours
review recommendations. Advice will also be published on what
the service needs to do to deliver accreditation and meet new
regulation.
For further
information please contact Carole Griffiths at carole.griffiths@doh.gsi.gov.uk
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Supplementary
lists of non-principals
From 1 June
this year GMS GP principals in England will be responsible under
their terms of service for ensuring that any assistant or deputy
they employ is on a PCT or health authority supplementary list.
These new
lists are intended to ensure that a minimum number of essential
checks are made before a doctor is allowed to treat patients.
But they do not take away the responsibility of a GP principal
to ensure that the doctor they employ as an assistant or deputy
is appropriately experienced.
Health authorities
are now setting up local supplementary lists of doctors who work
as deputies or assistants in GMS. This includes associates, assistants,
salaried GMS doctors, retrainees, locums and GP Registrars. PCTs
will from April onwards progressively take over management of
these lists.
To continue
to support GP principals in the provision of GMS after 1 April,
non-principals must apply to join a health authority supplementary
list before 28 February. Once the application has been submitted
the non-principal is free to continue to work whilst their application
is decided. PCTs and health authorities have until 31 May to complete
this process. This phased process will ensure both continuity
of support for GP practices and employment for non-principals.
Non-principals
who apply after 28 February will not be entitled to work in GMS,
and must not be engaged by a GP principal after 1 April, until
their application has decided by the PCT or health authority.
Health authorities
are sending application details to known locums, and other non-principals,
in their areas. GP principals can help their health authority
by asking locums and any other non-principals linked to their
practice if they have applied. If they have not, they should be
encouraged to do so straight away.
Lists of doctors
working in PMS will be introduced later this year. Until these
lists are introduced, any doctor who is named in a PMS contract
does not need to apply to join a supplementary list. Any doctor
wishing to work as a locum exclusively in PMS does not need to
join a supplementary list. However, these doctors will wish to
seriously consider joining the supplementary list so that they
can work as a locum in both PMS and GMS.
Once the PMS
lists are introduced, any doctor working in PMS — whether
named in a contract or not — will be required to be on a
PCT/strategic health authority list.
Any queries
can be addressed to Jenny Smith on 0113 2545825 or email at jenny.smith@doh.gsi.gov.uk
providing contact details and stating which health authority has
been approached.
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New GP
contract negotiations
Work on developing
the new GMS contract is now under way. The NHS Confederation’s
core negotiating team has been meeting monthly with the BMA’s
General Practitioners’ Committee (GPC) since last October.
So far it is reported that the work has progressed constructively.
The two negotiating teams are in agreement that the new contract
must:
- meet
patients’ needs;
- recognises
appropriately GP’ contributions to health and health
care;
- addresses
issues of recruitment and retention in the profession;
- can be
implemented flexibly to suit local circumstances.
In seeking
to achieve this they will:
- emphasise
and reward quality and appropriate responsiveness to patients,
needs;
- recognise
the roles of other members of the extended primary care team
and colleagues working in the secondary, social and voluntary
sectors;
- recognise
the contribution that can be made by an extended range of
services;
- promote
the culture of clinical governance and service improvement.
To promote
recruitment, retention and professional morale. They will:
- address
issues of workload and capacity in primary care;
- encourage
more flexible employment arrangements and career option;
- promote
lifelong learning and opportunities for continuing professional
development.
They will
also identify the balance between the elements that will be set
nationally and those that can be determined locally.
In open letters
to their respective members, NHS Confederation and the GPC outlined
that the new contract will provide a variety of contractual options,
given the "one size fits all" solution is no longer
practicable. Creating a flexible contract is likely to rely on
a greater role for other primary care members.
Both teams
still have much detailed work to complete before they are able
to agree meaningful proposals for a contractual framework, which
the BMA can put to the profession. If the decision of the profession
is positive, detailed pricing will then be required, followed
by a period of implementation and transition. Some changes may
also require primary legislation and will, therefore, require
suitable parliamentary time.
Any queries
can be addressed to Mark Smith on 0113 2546385 or alternatively
email him at: mark.smith@doh.gsi.gov.uk
Further updates
are available from the NHS Confederation website at: www.nhsconfed.net/priorities/gpcontract
and any views or comments can be e-mailed to gpcontract@nhsconfed.co.uk.
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NHS LIFT
Schemes
NHS LIFT is
a public-private partnership (PPP) designed to help develop and
improve primary care premises. It aim is to help meet the NHS
Plan targets of 500 new one-stop primary care centres and improvement
or refurbishment of up to 3000 GP premises by 2004.
In the model
proposed by NHS LIFT it is possible to buy out some GPs from their
existing premises in negative equity. Those who want to put in
capital investment can sell to LIFT and make a general return.
The first
wave of six LIFT schemes were launched in February 2001, followed
by the announcement of a further 12 schemes in the second wave.
A third wave of LIFT schemes is expected later this year. A number
of inner city and rural areas will be encouraged to consider putting
forward plans.
Further information
about NHS LIFT is available at www.doh.gov.uk/pfi.htm
For enquiries,
please contact Liz Kidd at the Department at: liz.kidd@doh.gsi.gov.uk
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Performance
Analysis Toolkit
In response
to a demand from healthcare professionals, the Department of Health
has recently issued the latest version of the Performance Analysis
Toolkit (PAT) to Primary Care organisations, NHS Trusts and Health
Authorities.
Version 2.0
of PAT is available on CD-ROM and holds anonymised practice level
data on separate diskette.
PAT is a benchmarking
tool that provides analysis of national inpatient data and has
been designed to support primary care organisations in the commissioning
of secondary care services.
The toolkit
provides geographical representations of admission rates to hospitals
for PCG/Ts and health authorities, as well as provider performance
such as length of stay, readmission rates, waiting times and treatment
costs. It allows PCG/Ts to judge how their organisations are performing
in these areas compared to other PCG/Ts, and whether their provider’s
performance is as would be expected. Knowing how well the system
is working today can help shape better patient services.
The Department
of Health has involved various healthcare professionals in the
development stages of PAT. This input has been essential in ensuring
that the next version of the toolkit is user-friendly and easily
accessible. The feedback received so far indicates that healthcare
professionals have been impressed with the toolkit and the analysis
it offers. Work is currently in hand to develop a web-based version
of the toolkit, to provide Primary Care Professionals with more
accurate and timely data.
For further
information on the toolkit, please contact
Dr Shaleel
Kesavan on 0113 2545954, email: shaleel.kesavan@doh.gsi.gov.uk
To obtain
a copy of the latest version, please contact Tamara Newton by
email at: tamara.newton@doh.gsi.gov.uk
September
2001 GP Census — Results
The results
of the September 2001 GP census can be found at www.doh.gov.uk/public/nhsworkforce.htm
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Revised
PMS Agreement Framework
A revised
PMS Agreement Framework, which was announced on 17 January, has
been widely welcomed. The agreement replaces the previous "core
contract", following widespread consultation with interested
parties, and after listening carefully to the concerns of GPs.
The main points
of change keep bureaucracy to a minimum and make sure that targets
are achievable. They are:
- a smaller
set of minimum national requirements;
- simpler
and clearer definitions — in particular, the access targets
of 24/48 hours have been clearly defined;
- clarification
that the requirement for 30 hours’ continuing personal
and professional development may include what is already taking
place — it is not an additional requirement;
- the dropping
of the requirement for an annual report. It become clear that
this would be an unnecessary burden on staff. In addition, the
annual report is no longer a requirement in General Medical
Services.
For further
information, please contact Sarah Bird on 0113 2545010 or email:
sarah.bird@doh.gsi.gov.uk
The Bulletin in
Portable Document Format 
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