1. Successful Implementation New GMS and PMS Rob Webster Director, contract implementation

2. Context n GP most respected public figure n Primary Care highest satisfaction rate n Primary care internationally admired n Quality is improving n PCTs as inclusive organisations n New contracts mean we are in the verge of a renaissance in Primary Care

3. Scope [England] n c300 million consultations n c1m specialist attendance n 6 million NHS D calls n 6 million on-line hits n over 7 million OOHs calls n c1 million WiC attendances n 600 million items dispensed

4. Timetable n October 2003 - first payments n November 2003 - finance exercises n December 2003 - guidance, SFE, Model contract, regulations, IAU/ICB tools n February 2004 - main allocations n March 2004 - contracts signed n April 2004 - new legislation, 1st payments n Dec 2004 - OOHs changes complete

5. PCT/Practice actions n Strategy for commissioning primary care n 1st Jan: offer 2003/04 access & QUiP DES n End Jan: reviewed additional services commissioning & contractor intentions n 1st Feb: commission violent patients DES n End Feb: drawn up initial plans for commissioning enhanced services; agree quality aspiration n before 5 March: agreed practice areas, open/closed status, discussed normal hours, offered 3 DES, agreed early additional service opt-outs, signed contracts n 7 March: offer default contract where necessary n Apr: set up assessment panels & proposals for assignments if need be

6. Conditions for satisfaction [1] n All GMS practices have signed contracts or have been offered the default contract by 7 March n All PMS practices have begun discussions on amendments to their contracts around QoF, OOHs etc

7. How? n Central programme management n SHA role in PCT management n MA role in support –PCTs –Practices n Confederation networks n GPC support and LMCs

8. Primary Care Quality (What Patients Value) n Availability and Accessibility n Technical Competence n Communication Skills n Interpersonal Attributes of Care n Continuity of care n Range of On-Site Services

9. Conditions for satisfaction [2] n Patient values are supported n Patient services are improved

10. How? n Patient services guarantee with new provider options n Patient experience aspects of QoF n More information for patients n Guaranteed investment

11. Strategic Vision n Universal, fast and convenient access n by informed patients n to an extended choice and range of high quality services n delivered in modern primary care settings n by suitably trained and qualified professionals

12. Conditions for satisfaction [3] n Contracts support the strategic development of primary care n Primary care is at the heart of strategic development in the NHS n GPs and their teams morale improves

13. How? n 9 strategic tests for PCTs n MA support programme n Investment n Relationships

14. GP opinion: 2001 n Longer consultations n Smaller lists n A quarter want to leave within 5 years n Half will retire before 60 n A fifth find stress unmanageable n two thirds see morale at a low

15. Conditions for satisfaction [4] n GP opinion changes! n Morale and recruitment and retention

16. How? n Implementation of contract in spirit which it was agreed n Two way relationships n Inclusive PCTs

17. Summary n Alignment - principles, vision, values n Positive Context, Huge Scale n Operations, patient care, strategy, GPs n Primary Care at the centre of NHS reform n Contracts deliver that strategy