NHS Circular: PCA(M)(2010)19 Primary and Community Care Directorate Primary Care Division abcdefghijklmnopqrstu Dear Colleague 15 October 2010 ___________________________ GENERAL MEDICAL SERVICES STATEMENT OF Addresses FINANCIAL ENTITLEMENTS FOR 2010/11 For action Chief Executives NHS Boards Summary General Medical Practitioners For information Director of Practitioner Services 1. This Circular introduces a revised Statement of Division, NHS National Services Financial Entitlements (SFE) for GMS Contractors and Scotland replaces PCA(M)(2009)15 issued on 29 October 2009. ___________________________ 2. The SFE has been agreed with the Scottish General Written enquiries to: Practitioner’s Committee. and specific details to sections of Mike Bell the SFE are detailed at Annex A. 1 East Rear St Andrew’s House 3. An electronic copy of the SFE can be found on the NHS EDINBURGH EH1 3DG website at Fax: 0131-244 2621 http://www.sehd.scot.nhs.uk/pca/PCA2010(M)19.pdf ___________________________ Action 4 NHS Boards are requested to bring this Circular to the attention of GP practices in their area and their Local Medical Committee for the attention of the Secretary of the GP sub-committee. Yours sincerely FRANK STRANG Deputy Director, Primary Care Division St Andrew’s House, Regent Road, Edinburgh EH1 3DG www.scotland.gov.uk abcde abc a Annex A Amendments made to SFE effective from 1 April 2010 issued 15 October 2010. Amendment of the Table of Contents In the Table of Contents in Part 1 Section 3(Minimum Practice Income Guarantee), for the heading “Review and revision of Correction Factor Monthly Payments in respect of the financial year 2009/2010” substitute “Review and revision of Correction Factor Monthly Payments in respect of the period 1 April 2010 to 31st March 2011 Amendment to Introduction Updated to reflect the current dates and effective date of SFE. Amendment of Part Section 2 – Global Sum Payments. In paragraph 2.3 remove – “Calculation of Initial Global Sum Monthly Payment for 2009/10 and replace with” (ii) Calculation of Initial Global Sum Monthly Payment for 2010/11 For 2010/11 only, the following steps will be carried out in implementing the Review Body on Doctors’ and Dentists’ Remuneration’s recommended methodology for applying the 2010/11 uplift: • The contractor’s share produced by the calculation in paragraph 2.3 (i) together with the contractor’s correction factor will first be increased by 0.41%. Then the following steps will be carried out: • The contractor’s share produced by the calculation in paragraph 2.3 will be further increased by 0.65%. • Then the annual amount of the contractor’s Temporary Patients Adjustment will be added. • Then opt-outs as described in paragraph 2.5 below will be deducted • Then the correction factor (as adjusted above) will be reduced by the additional amount allocated as a result of the further increase of 0.65% outlined above in this paragraph, unless this results in a negative correction factor in which case the correction factor will be taken to be zero Then the following steps will be carried out: • The difference between the total increase of 0.65% and the final increase resulting from the above steps including adjustment of correction factor will be reallocated to the contractor’s share produced by the calculation in paragraph 2.3 • Then the annual amount of the contractor’s Temporary Patients Adjustment will be added • Then opt-outs as described in paragraph 2.5 below will be deducted • Then the correction factor will be adjusted by reducing it by the additional amount allocated as a result of the previous steps outlined above in this paragraph, unless this results in a negative correction factor in which case the correction factor will be taken to be zero The above steps will be continued to be applied until all of the original 0.65% has been allocated. Paragraph 2.4 is amended to read – For comparative purposes only, the resulting amount should correspond to the Contactors Weighted Population for the Quarter multiplied by approximately £69. This figure is calculated by taking the total global sum amount for Scotland (£387.7m), subtracting the total sum allocated for Temporary Patient Adjustments and then dividing by the Scotland-wide registered population for the Quarter. The resultant amount is then to be divided by twelve, and the resulting amount from that calculation is the contractor’s initial GSMP for the financial year. Footnote 3 is amended to read – The figure of £387.7m takes effect with this SFE on 1 April 2010 and includes non-GMS practices. The equivalent figure prior to 1 April 2010 was £378.1m. The new figure reflects the implementation of the Scottish Government agreed 2010/11 uplift and the change to Scotland’s registered population for the period 1 April 2009 to 31 March 2010. Paragraph 2.18 Contractor Population Index is amended to read- The Contractor Population Index (CPI) of a contractor, mentioned in paragraph 2.16, is the contractor’s most recently established CRP divided by 5170. Where reference is made in this SFE to a contractor’s CPI, that reference, unless the context otherwise requires, is to the most up-to-date version of the contractor’s CPI at the time that the payment which is being adjusted in accordance with a calculation using the contractor’s CPI falls due. Footnote 4 is amended to read – The figure of 5170 takes effect with this SFE from 1 April 2010. The equivalent figure prior to 1 April 2010 was 5150. The new figure reflects the notional change in the Scotland’s registered population for the period 1 April 2009 to 31 March 2010. Amendment of Section 3 – Minimum Practice Income Guarantee Paragraph 3.12 (b) is amended to read – for the financial year 2010 to 2011, by 0.41% of the practices’ CFMP. This calculation is made in order to implement the Scottish Government agreed uplift for 2010/11, in that the first half of the total uplift is to be applied across global sum, correction factor, quality and outcomes framework, enhanced services and locum payments in proportion to their 2009/10 spend. This will result in the creation of new temporary Correction Factors for those practices which have no existing Correction Factor; and Paragraph 3.12 (c) is amended to read- for the financial year 2011 to 2012 and subsequent financial years, by- (i) the percentage by which the amount specified in paragraph 2.3 is uprated at or for the start of the new financial year (“the Uprating Percentage”), if it is to be uprated, or (ii) if the amount specified in paragraph 2.3 is not to be uprated at or for the start of the new financial year, by 0%. Amendment of Section 4 Paragraph 4.14 is amended from : “The standards set relate either to a task to be performed or an outcome to be achieved. The points available in relation to these indicators are only obtainable (and then in full) if the task is in fact accomplished or the outcome achieved. Guidance on what is required to accomplish the task or achieve the outcome is given in Section 3 of the QOF”. To “With the exception of the indicator “records 23” in the records and information sub-domain( the percentage of patients aged over 15 years whose notes record smoking status in the past 27 months), the standards set relate either to a task to be performed or an outcome to be achieved. The points available in relation to these indicators are only obtainable (in full) if the task is in fact accomplished or the outcome achieved. Guidance on what is required to accomplish the task or achieve the outcome is given in Section 3 of the QOF”. After paragraph 4.14 the following is inserted: 4.14A “Records 23” has designated achievement thresholds and the standard of the performance of the contractor is to be assessed in accordance with Section 4.8 to 4.12”. Paragraph 4.15 has been amended to read- This domain, in Section 4 of the QOF, contains three indicators, all of which relate to patient experience: The first is about the length of patient consultations and the second and third indicators are about patient experience of access. The method of calculating the number of points earned under the indicator relating to the length of patient consultation is set out in paragraph 4.16. The method of calculating the number of points earned under the indicators relating to patient experience of access is set out in paragraphs 4.17 to 4.18E. Paragraph 4.17 has been amended to read- The two indicators relating to patient experience of access have designated Achievement Thresholds. The contractor’s performance against the standards set out in these indicators is assessed on the basis of percentage of patients who, in the national patient experience survey carried out during the relevant financial year, or for 2010/11 the most recent survey in which the practice participated, indicate in respect of that contractor that they were able to obtain a consultation or book an appointment in accordance with the time limits required by the standards set out in the indicators. Paragraph 4.18 has been amended to read- From 2011/12, if the contractor does not participate in the biennial national patient experience survey, the contractor is not entitled to any points in respect of those indicators. If the national patient experience survey does not generate results for the contractor in respect of either indicator, the contractor is not entitled to any points in respect of that indicator. Paragraphs 4.18BA to 4.18BC are removed.