Oxfordshire Clinical Commissioning Group Neighbourhoods / Primary Care Networks and Long Term Plan February 2019
Purpose Oxfordshire Clinical Commissioning Group • This slide deck provides an update on the implications of the Long term plan published 7 January 2019 with specific reference to Primary Care and primary Care Networks • It takes into account the Operational Planning and Contracting Guidance and the newly published five year framework for GP contract reform to implement the Long Term Plan • Content is intended to provide highlights not a full summary of all content
Oxfordshire Oxfordshire Clinical Commissioning Group
City Locality Oxfordshire Clinical Commissioning Group City Central 55,372 Neighbourhood total City East 43,066 Neighbourhood total City Headington 43,391 Neighbourhood total City North 46,983 Neighbourhood total City East 40,824 Neighbourhood total Locality total 229,636 As of 01/01/2019
City Locality Oxfordshire Clinical Commissioning Group City Central Beaumont St (19) 16,016 Beaumont St (27) 7,296 Luther Street Medical Centre 490 Beaumont St (28) 5,719 King Edward Street 5,664 Botley Medical Centre 15,718 South Oxford Health Centre 4,469 Neighbourhood City North total 55,372 Summertown Health Centre 17,359 Banbury Road (172) 9,125 City East Observatory Medical Practice 11,370 St Bartholomews MC 19,603 Jericho Health Centre Bartlemas Surgery 8,760 (Leaver) 9,129 Neighbourhood total 46,983 St Clements Surgery 5,108 Cowley Road Medical City South East Practice 9,595 Neighbourhood Donnington HC 13,336 total 43,066 Temple Cowley Health Centre 8,098 The Leys Health Centre 10,459 City Headington Hollow Way Medical Centre 8,931 Hedena Health 26,681 Locality total 229,636 Neighbourhood total 40,824 Manor Surgery As of 01/01/2019 Headington 16,710 Neighbourhood total 43,391
Vision from Long Term Plan Oxfordshire Clinical Commissioning Group Fully integrated community based health care Achieved by: • Boosting ‘out of hospital’ care • Primary care Networks / Neighbourhoods • Enhanced staffing and expanded community multidisciplinary teams • Care home coverage • Proactive approach to ageing population • Increased funding with single designated fund • Significant changes to QOF • A new shared savings scheme • Digital first primary care
Contract Reform Headline changes Oxfordshire Clinical Commissioning Group • Core general practice funding will increase by £978 million a year by 2023/24 • Increase to global sum, this year, £109m will be invested into the ‘core practice contract’ - in subsequent years, core funding will increase significantly • Indemnity costs for all GPs and practice staff will be funded on top of the global sum increases every year for the next five years • A Primary Care Networks (PCN) contract will be introduced from 1 July 2019 as a Directed Enhanced Service (DES) provision of funds will be at PCN level • 20,000+ additional staff by 2023/24 - Workforce fund (worth £900m by 2023/24) to fund practice staff to support GPs • Digital first and improving access focus
Primary Care Networks Oxfordshire Clinical Commissioning Group PCNs - the building blocks for integrated care • Enable the provision of proactive accessible, co-ordinated and more integrated primary and community care • Formed around natural communities based on GP registered lists • Serve populations of around 30,000 – 50,000 patients • Small enough to still provide personal care but large enough to have deeper impact by collaboration • Collaboration between practices and others in the local health (community and primary care) and social care system • Platform for providers of care being sustainable into the longer term • Oxfordshire is using the language of neighbourhoods
New GP contract - PCNs Oxfordshire Clinical Commissioning Group Primary Care Networks (PCN) contract will be introduced from 1 July 2019 as a Directed Enhanced Service (DES) • Technically ‘voluntary’, NHS England and the BMA expect 100% take up = 100% of patient population covered • To qualify for the funding from July 2019, practices will need to join networks and appoint a clinical lead • Financial support of £1.50 per patient – in cash not kind • Financial support given for the clinical lead role (0.25 WTE per 50k population) • PCNs will have to work towards seven ‘service specifications’ based on the aims of the NHS long-term plan
Workforce Oxfordshire Clinical Commissioning Group • Workforce fund (worth £891m by 2023/24) to fund 20,000+ additional practice staff to support GPs • Additional role reimbursement scheme from 1 July 2019 • Recurrent for 5 years – no taper or increase (AfC linked) • networks will receive 70% of the funding to employ additional roles 100% for social prescriber • Phased approach: 2019/20 pharmacists and social prescribers / link workers 2020/21 physician associates and first contact physiotherapists 2021/22 Community Paramedics • This is aimed at additional roles – reimbursement will only be for demonstrably additional people (not fill existing vacancies or subsidise existing staff) [exception for some pharmacists]
Integrated Working Oxfordshire Clinical Commissioning Group • Delivery of integrated primary and community health will be supported by integrated multidisciplinary teams to comprise of: GPs Pharmacists District Nurses Community geriatricians Dementia workers Physios Podiatrists/chiropodists • Consideration will need to be given to scale and ways of working • Data analysis and population health management functions will be critical to enabling proactive and preventative care
Significant changes to QOF Oxfordshire Clinical Commissioning Group QOF reformed to remove ‘unnecessary indicators’, to bring in ‘clinically-proven improvements’ for the management of prevalent conditions • QOF currently comprises 559 points; 28 indicators worth 175 points (31% of the complete scheme) - will be retired from April 2019 • 101 points will be recycled into 15 more clinically appropriate indicators over five areas • NHS England and GPC England have agreed to replace the current blunt system of exception reporting with a more precise ‘personalised care adjustment • The remaining points indicator retirement will be used to create two one year Quality Improvement modules om 2019/20 prescribing safely and end of life care
Time table for DES introduction Oxfordshire Clinical Commissioning Group https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf
Points to consider Oxfordshire Clinical Commissioning Group • Network arrangements • Benefits of delivery some aspects of work at scale • Integration with wider community services including mental health and social care • Employing arrangements • Support and enabling role of Federations • The network agreement is the formal basis for working with other community based organisations – wide membership • PCNs are the building blocks of integrated care • All network contracts within a CCG will be confirmed at the same time
To leave you with Oxfordshire Clinical Commissioning Group • Some pump priming money to support some of these initial conversations and discussions Working together Required infrastructure Workforce implications Digital opportunities • Wider content covers much more GP salary transparency Employer pension contributions Personal pensions Joining up the urgent and emergency care system Digital access and enablement
Recommend
More recommend
