Implementing the 2018/19 GP contract

Transcription

1 Implementing the 2018/19 GP ontrat Changes to Personal Medial Servies and Alternative Provider Medial Servies ontrats

2 Implementing the 2018/19 GP ontrat Changes to Personal Medial Servies and Alternative Provider Medial Servies ontrats Version number: 1 First published: July 2018 Prepared by: GP Contrats Team, Medial Diretorate Classifiation: OFFICIAL Gateway Publiations Referene: Promoting equality and addressing health inequalities are at the heart of NHS England s values. Throughout the development of the poliies and proesses ited in this doument, we have: Given due regard to the need to eliminate disrimination, harassment and vitimisation, to advane equality of opportunity, and to foster good relations between people who share a relevant proteted harateristi (as ited under the Equality At 2010) and those who do not share it; Given regard to the need to redue inequalities between patients in aess to, and outomes from, healthare servies and in seuring that servies are provided in an integrated way where this might redue health inequalities. 2

3 Contents Contents Introdution Delivering a ommon inrease to ore funding Inreases to GMS global sum Inrease to PMS and APMS ontrats Out of Hours (OOH) opt out dedution Other funding hanges

4 1 Introdution NHS England is ommitted to an equitable and onsistent approah to funding the ore servies expeted of all GP praties. Following the hanges agreed to the General Medial Servies (GMS) ontrat for 2018/19, this doument sets out the approah to the funding hanges that NHS England will apply to Personal Medial Servies (PMS) and Alternative Provider Medial Servies (APMS) ontrats. NHS England teams will update loal PMS and APMS ontrats as soon as possible, applying the funding hanges identified with effet from 1 April Clinial Commissioning Groups (CCGs) working under delegation agreements will also apply the hanges to loal PMS and APMS ontrats in line with this guidane. For the avoidane of doubt, this guidane represents guidane CCGs must omply with and implement under the provisions of Part 1 of Shedule 2 (Delegated Funtions) of the Delegation Agreement made between NHS England and the CCG. The arrangements set out here are without prejudie to any potential hanges to the premium element of PMS or APMS funding as a result of loal reviews and renegotiations. 2 Delivering a ommon inrease to ore funding 2.1 Inreases to GMS global sum Global sum funding and uplift New investment for 2018/19 totals 256 million and inludes: a pay uplift of 1 perent; payments to over indemnity inflation osts (already paid) please see the guidane here; payments to over the non-reurrent osts of implementing the Eletroni Referrals System; an inrease in the value of a Quality and Outomes Framework (QOF) point to , resulting from the updated Contrator Population Index (CPI); An inrease in the item of servie fees for seleted Vainations and Immunisations from 9.80 to 10.06; and osts and other inreased business expenses. NHS Employers, NHS England and GPC will work in 2018/19 to determine an agreed methodology for expenses whih all parties might use in future. The GMS global sum funding will also inrease in 2018/19 as a number of funding streams are transferred: the phasing out of the Minimum Pratie Inome Guarantee (MPIG) - orretion fator - payments began in 2014/15 and will ontinue through to 2020/21. MPIG payments are being redued by one seventh of the 2013/14 payment and the 4

5 aggregate funds reinvested into GMS global sum with no out-of-hours (OOH) dedution applied; and the implementation of phasing out of seniority payments 1 began in Otober 2015 and will ontinue through to Marh 2020, with a redution in payments and simultaneous reinvestment into ore funding every year. The net effet is that: Global sum payment per weighted patient inreases from to 87.92; GMS OOH dedution hanges from 4.92 perent in 2017/18 to 4.87 perent in 2018/19. These revised values take effet from 1 April 2018 as detailed in the Statement of Finanial Entitlements (SFE). A ready rekoner has been developed whih GMS praties an use as a rough guide to estimate the hange in their funding as a result of the ontratual hanges in 2018/19. The ready rekoner is indiative only and does not onstitute finanial advie to praties. Nor does it reflet any national modelling for assessing pratielevel impats of ontrat hanges. 2.2 Inrease to PMS and APMS ontrats To deliver an equitable and onsistent approah to uplifting PMS and APMS ontrats ommissioners (NHS England teams or CCGs under delegation agreement) inreases will apply for those GMS hanges that also impat on these arrangements that are equivalent to the value of the inreases in the GMS prie per weighted patient. In summary, GP praties will reeive inreases in ore funding as set out in table 1. 1 NHS Employers. 5

6 Table 1 GMS PMS APMS /weighted patient /weighted patient /weighted patient. MPIG reinvestment Seniority reinvestment Inflation uplift Total uplift A [ 0.41] B [ 0.41] C A+B+C [ 2.57] - - [ 0.41] b+ [ 2.16] - Commissioners will need to apply the tariff(s) identified in table 1 above to alulate the inreases due to individual PMS and APMS praties. To alulate the inrease due will require the appropriate tariff(s) to be multiplied by the weighted list size of the pratie (or raw list if the loal ontratual agreement requires). Typially this will be the list size at the beginning of the quarter prior to the ommenement of the finanial year e.g. 1 January 2018 (unless the ontratual agreement speifies otherwise). MPIG reinvestment (A) is a redistribution of existing GMS funds. The resulting inrease in GMS global sum prie per weighted patient does not therefore need to be refleted in any inrease to PMS baseline funding or equivalent funding to APMS praties. Seniority reinvestment (B) is a redistribution of existing GMS and PMS funds. The resulting inrease in GMS global sum prie per weighted patient does therefore need to be refleted in any inrease to PMS baseline funding but must not be refleted in the equivalent funding to APMS praties as no redution of APMS seniority payments has been applied. However, any new APMS ontrats negotiated must exlude any payments in relation to seniority. Inflationary uplift (C) is the GMS prie inrease per weighted patient resulting from the Government s 1% uplift on pay, along with an appropriate uplift to expenses, leading to a ontrat uplift of 1.37 per ent. Commissioners will apply the equivalent uplift to PMS and APMS praties: tariff (C) in table 1 above. Seniority reinvestment As identified earlier there will be a further inrease from April 2018 to reinvest seniority payments into ore funding. This will see an inrease in GMS global sum based on weighted patient share one the quantum of funding being reinvested is identified. As many PMS arrangements have separately identified levels of funding equivalent to GMS seniority payments, ommissioners will apply an inrease based on the PMS weighted patient share. Where PMS praties have separately identified levels of funding for seniority payments these will also need to be redued in aordane with the redutions applied to the GMS seniority sale from 1 April

7 2.3 Out of Hours (OOH) opt out dedution Under the 2018/19 GMS ontrat agreement, where MPIG, enhaned servie and seniority funds are reinvested in GMS global sum, this will be done without any OOH dedution. NHS England will ahieve this by reduing the perentage value of the OOH dedution for opted-out GMS praties to a level that disounts the reinvestment of funding. As the reyling of MPIG with no OOH dedution is a redistribution of existing GMS funds the resulting derease in the OOH dedution does not need to be refleted in the equivalent OOH dedution made to PMS or APMS praties. Where no OOH dedution is made in PMS or APMS ontrats (i.e. OOH opt out never featured in the ontrat or was permanently removed) no further ation is required. Where there is an agreed dedution, this should be onsistent with the revised GMS OOH dedution. The ash value of the PMS OOH dedution per weighted patient for 2018/19 is therefore also The PMS perentage redution is determined by applying the GMS OOH ash dedution to the PMS prie per weighted patient (whih is GMS global sum prie per weighted patient less umulative MPIG reinvestment = minus 2.49, giving 85.43). So 4.28 gives a redution of 5.01% from Commissioners will apply the OOH dedution of 4.28 per weighted patient to the weighted list size (unless ontratual agreement provides for raw list size) of the PMS or APMS pratie to alulate the value of the OOH opt out dedution. 2.4 Other funding hanges The funding/payment hanges below also apply in 2018/19 following hanges to the GMS SFE and ommissioners will need to repliate the terms set out in the SFE in PMS and APMS ontrats as appropriate: a. Quality and Outomes Framework the pound per point value inreases from to as a result of Contrator Population Index (CPI) adjustment. b. Loum allowanes for sikness, maternity, paternity and adoption leave will be inreased by 1% - in aordane with the SFE amendment; and. Seleted V&I uplift the item of servie fee has been inreased from 9.80 to Commissioners should refer to the main implementation guidane for details on hanges to enhaned servies and other servies in 2018/19 and this an be found on the GP ontrat pages of the NHS England website. Other formats of this doument are available on request. Please send your request to england.gpontrats@nhs.net 7