Richard Armstrong Head of Primary Medical Care Contracting Department of Health
Practice-led Commissioning What is it ? Why Legal Framework Mechanics
Government Policy Themes Decentralisation STBoP Foundation Trusts Care/Children Trusts Systems Reform nGMS/nPMS Improving Performance Modernisation Agency/SHAs CHAI/Star ratings Improvement Plans
PCTs: The challenges Delivering the LDP Access NSFs Other National priorities (Health Inequalities, Drugs etc) System Reform Choice Payment by results Foundation Trusts Secondary to primary care shift Contracting for Primary Care provision Real clinical and public engagement
PCTs: The challenges The real challenge Matching demand with capacity, whilst meeting Need!
Practice-led Commissioning WHY? Empowering & engaging clinicians Choice, Access, Payment by Results Providing clear mechanisms for accountability Allows innovation – creating plurality of provision It works
Practice-led Commissioning WHY NOT Perverse incentives Distortions and gaming Transaction costs Alienating the profession
Practice-led Commissioning Legal framework Rights & Responsibilities - Clinical Team - PCT Down to PCT to determine - scope - range and - form of arrangements Not complete (or single) answer
Practice-led Commissioning Mechanics Setting budgets -Historic -Weighted Capitation -Something else Managing Risk -Over/Under spends -Stop Loss/over time Monitoring & Feedback mechanisms Contracting
Primary Medical Care – an update nGMS 99.8% signed Getting practices paid Managing disputes Superannuation (employers cont) PMS Quality points OOHs opt out price Contract variations PCTMS/APMS Guidance & Directions