Over the past few months we have been developing our Primary Care Investment plans taking account of the funding streams available to us both nationally and under Delegated Commissioning. The CCG is still facing a very challenging financial position for 2018/19. However, we are committed to continuing to support the development of a strong, transformed primary care service as a vital element of our whole system transformation work. This forms part of our strategy to deliver a sustainable local NHS and aligns us to delivering the GP Forward View.
We are now in a position to confirm our proposals for investment through our Local Enhanced Service Offer and our wider Primary Care Investment Programme. This has been developed in consultation with the LMC, and approved by the CCG’s Primary Care Commissioning Committee and Governing Body
Our 2018/19 local primary care investment and commissioning plans represent a significant investment of £13m by the CCG against the £10.4m committed in 2017/18.
Reinvestment of PMS Premium Re-basing Monies 2018/19
The PMS premium released through re-basing all PMS contracts over a 4/5 year period is ring fenced for investment back into in GP practices through agreement between
NHS England and the CCG, in consultation with the LMC. Historically this has been utilised to strengthen the local investment committed in the enhanced service portfolio
and QEF. Funds received to date, along with the 2018/19 PMS rebasing (£1.725m) form the budget to support this local investment plan.
Quality and Engagement Framework 2018/19
For 2018/19, the Primary Care Commissioning Committee agreed to roll forward the 2017/18 QEF for a period of 3 months from 1st April 2018 until 30th June 2018 whilst the CCG, along with the LMC, develop a revised Framework, effective from 1st July 2018.
For the revised framework, the CCG is proposing to build on the components from the 2017/18 QEF relating to CCG engagement; demand management improving the quality of referrals; and medicines Optimisation, and to utilise some of the 2018/19 rebasing allowance (£1.725m), to support the introduction of an additional quality assurance component. This additional component is to support engagement in a new Quality Assurance Framework that the CCG is developing along with some clinical outcome measures.
The finalised Quality and Engagement framework for 2018/19 will be communicated to GP practices in due course
Local Enhanced Services 2018/19
It has been agreed to roll forward our existing Local Enhanced Service agreements into 2018/19 to reflect continuation of existing services for patients from April 2018.
Given the CCGs current financial position, and recognising that many of these services support historical commissioning arrangements, a number of services included within the portfolio of local enhanced services commissioned from general practice will be reviewed during the first quarter of 2018/19. The review will serve to evaluate whether the services commissioned are still relevant and meet local needs, whilst assuring the CCG that they deliver value for money in the context of the wider CCG financial stability. Once the review is complete, the CCG will liaise with the LMC and notify Practices of the outcome, advising on any changes to the current commissioning arrangements going forward.
The CCG wants to ensure that there is population coverage and that patient access to services remains fair and equitable across the county. We are therefore encouraging Practices/Federations to further explore how they may work collaboratively, at scale, to deliver the full suite of enhanced services during 2018/19. In addition, we would encourage more effective partnership working with neighbourhood teams to ensure patients are not disadvantaged and services are delivered safely, effectively and efficiently.
The Local Enhanced Service Specifications to support service delivery remain largely unchanged for 2018/19. The Service Level Agreements for each service can be downloaded by clicking on drop down list under 'Downloads' on the right hand side of the page.