Contract changes 2012/13

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18 / 10 / 2011

NHS Employers and the General Practitioners Committee (GPC) of the BMA agreed changes to the General Medical Services contract for 2012/13 for England, Scotland, Wales and Northern Ireland.

Contents

GP pay

In recognition of the general state of public finances and the efficiency contribution expected of General Practice, NHS Employers and GPC negotiators agreed that in line with Government policy there would be no uplift to General Medical Practitioners’ net pay in 2012/13.

Expenses uplift (0.5 per cent)

For 2012/13 the overall value of GMS Contract payments would rise by 0.5 per cent, to support practices in meeting the costs of increased expenses, including pay increases for employed staff with a full time equivalent salary of less than £21,000. This uplift was delivered in England through an increase in the value of a QOF point.

The increase in the value of a QOF point was intended to deliver the full 0.5 per cent expenses increase. 

Quality and outcomes framework

The main changes to the Quality and Outcomes Framework for 2012/13 were:

  • the retirement of seven indicators (CHD13, AF4, QP1, QP2, QP3, QP4, QP5) releasing 45 points and the reduction of points from a number of indicators (total 26 points) to fund new and replacement indicators
  • the replacement of seven indicators with eight NICE recommended replacement indicators, focusing on six clinical areas namely Diabetes, Mental Health, Asthma, Depression, Atrial Fibrillation and Smoking
  • the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (Atrial Fibrillation, Smoking, PAD and Osteoporosis)
  • the introduction of three new organisational indicators for improving Quality and Productivity which focus on accident and emergency attendances
  • a number of threshold changes as follows:
  1. raising all lower thresholds for indicators currently 40-90% to 50-90%,
  2. raising all lower thresholds for indicators currently with an upper threshold between 70-85% to 45%

  3. a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31 COPD10, and CKD5

  4. lower and upper threshold changes for BP5, MH10 and DEM2.

Clinical directed enhanced services (England) 

The following existing Clinical Directed Enhanced Services (DESs) were re-commissioned by Primary Care Trusts, in England, for the twelve-month period ending on 31 March 2013:

  • the alcohol reduction scheme, and
  • the learning disabilities health check scheme.

The requirements of these clinical DESs remained the same and the payment scheme mirrored the payment scheme at the same rate that applied for the period 1 April 2011 to 31 March 2012.

The Osteoporosis DES was no longer available from 1 April 2012 in England, Scotland and Northern Ireland. The GMS portion of the funding from the DES was to be reinvested in the global sum with no corresponding increase to correction factor payments. Any money released through reductions in correction factor payments was to be reinvested back into the global sum.

Extended hours directed enhanced service (England)

The Extended Hours DES was extended by one year to 31 March 2013. The requirements and payment scheme remained the same as that applied for the period 1 April 2011 to 31 March 2012.

Patient participation directed enhanced service (England)

The Patient Participation DES was introduced for two years in April 2011 and so continued into 2012/13.

Patient choice scheme and practice boundaries (England)

A pilot programme to test and evaluate two different models for giving people greater choice of GP practice was introduced in April 2012. The pilot areas are Central London: Westminster, City & Hackney and Tower Hamlets; Manchester and Salford and Nottingham City.

Under the pilot arrangements, people who live outside the practice area were able to either:

  • register with a participating GP practice as an out of area patient (in which case they would cease to be registered with their current GP practice); or
  • have a consultation at a participating GP practice as a non-registered 'day' patient (in which case they would remain registered with their existing GP practice).

Practice boundaries

As part of the 2012/13 negotiations NHS Employers and the GPC also agreed that GP practices would agree with their PCT an outer practice boundary area where they would retain, where appropriate, existing patients who had moved house into the outer boundary area.

By 1st July 2012, practices and PCTs discussed and agreed variations to contracts or agreements which would establish an outer boundary area.

Other (England)

An agreement in principle that subject to the successful passage of the Health and Social Care Bill all GP practices in England would be contractually required to be a member of a CCG.

A commitment to explore risk profiling and case management with a view to introduce a scheme in April 2013.

A commitment to explore how the current global sum formula might be updated in the future to increase the weighting of deprivation factors.

 

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