The plan, which will be voted on by East Cheshire’s primary care co-commissioning committee on Thursday morning, could see every practice in the area paid £22.77 per patient to provide a range of non-core services. The committee includes representatives from East Cheshire CCG and NHS England.
The package will be funded with a £2m new CCG investment, £1.1m of existing locally commissioned service funding and £1.2m of reinvested PMS premium funding being withdrawn under NHS England’s equitable funding drive.
The CCG’s governing body has already agreed to provide the additional £2m a year for a new 'Caring Together' service developed with practices.
GP funding package
Board papers published ahead of Thursday’s meeting suggest that no other CCG is investing in the scope and scale of services planned by East Cheshire.
The new service specification will bring together a wide range of new and existing non-core services into a single CCG-wide contract with all services available from all GMS, PMS and APMS practices. The contract will take in services currently commissioned by the CCG, NHS England and public health. All 22 practices, if they all agree, will receive an aggregated per weighted patient price.
‘The new service specification will ensure that all 204,000 people registered with an Eastern Cheshire GP can enjoy access to the same services at an equitable standard within their local community, regardless of which practice they are registered with, and for the same level of funding per head of weighted population,' the paper said.
‘The proposal is patient-centred, and involves a shift of activity into the community, resulting in an increased focus on proactive and preventative care, improved patient experience and transparency of cost, reflecting best practice and national direction of travel.’
GP quality
It added: ‘Retention of the full levels of investment is dependent upon practices achieving the planned level of savings and required quality standards and outcomes.’
The document noted that despite the new investment 6 PMS practices in phase 1 and 2 in phase 2 of the scheme will receive less income than currently. The CCG said it will guarantee transition funding for them.
The scheme was described by commissioners as addressing underlying funding inequity as a prelude to the more radical changes outlined in NHS England’s Five Year Forward View.
Service all practices will have to provide for the scheme to go ahead, include:
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enhanced access to in-hours service including: electronic messaging, pre-bookable appointments for 2-6 weeks in advance, online record access, self care information on practice websites, telephone appointments.
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enhanced support for the population to stay well and to identify patients at risk of acute and chronic disease through lifestyle advice, referral and support and coordination of care, through introduction of an obesity management service, and a pre-diabetes service offering counselling, support and monitoring.
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enhanced/maintained support for people with long term conditions: including an anti-coagulation monitoring service, a diabetes service, a COPD service, a urology service, a gynaecology service, a dermatology service.
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enhanced level of procedures carried out in general practice, including: post-op dressing/stitch removal, routine dressings, hormone injection, prostate cancer diagnosis injection, ring pessary fitting and changing.
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enhanced/maintained level investigations in general practice, including: 24 hour BP monitoring, ECG reading and interpreting.
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enhanced support for complex needs from multimorbidities, social/emotional complexities or lack of secondary care support: continuation of proactive care service.
Cheshire LMC declined to comment.
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