nGMS and PMS Learning Exchange Programme

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nGMS and PMS Learning Exchange Programme

• Information and IMT
• The GMS Payments Project

January and February 2003
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Agenda

• Background and Context
• The Contract IT Implications
• Funding
• Ownership
• Minimum Functionality Specification and Business
  Case Guidance
• Service Level Agreements
• The GMS Payments Project
• NHAIS Payments The Exeter System
• QMAS (National QOF Management Payments System)
• Legacy systems and GMS compliance
• Suppliers
• Training
• PMS

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Background

• GMS Payments Project is part of NPfIT
• Scope
• Changes to GP systems
• Changes to payment systems
• Implementation of national QOF system
• Training and support for new and changed systems
• Project Board (chaired by Chris Town) and working
  groups
• Project Team of NPfIT and NHSIA people

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Context - NPfIT Aim

• To deliver a 21st century health service through
  the efficient use of information technology

• Improve quality and convenience of care by
  ensuring that those who receive care have the
  right information, at the right time.
• Implement projects vital to the NHS modernisation
  programme using IT to directly improve the
  patient experience and clinical care.

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Funding for GP Computer Systems

• 20m released to PCTs 05/11/03
• In addition to 50m in existing baselines
• Full 70m (ave. 8,000 per practice pa) should be
  allocated for GP IT before claiming additional
  funding
• 13 SHA s submitted claims for additional funding
  by 19/12/03
• Deadline extended to 31/12/03
• Claims being assessed to ensure equity and
  validity
• Practices must not be denied funding for core
  items (DH paper available)

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Ownership of Systems Transition Arrangements
4.30 as new money is spent on providing new
systems and upgrading existing systems, PCO
ownership of the asset and the responsibility of
the PCO to provide the full supporting service,
including maintenance, future upgrades, paying
for running costs of the new integrated systems
and training, will be established at the same
time.

• Still under discussion with BMA/NHS Confederation
• Status quo until there is agreement and guidance
  is issued

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Minimum Functionality Specification Business
Case Guidance
4.41 Work is continuing to develop a minimum
functionality specification for practice systems
that defines the information requirements to
deliver integrated care and meets the
requirements of the new GMS contract.

• GPC guidance list
• Core items which should normally be fully funded
• Non-core items which may be optional (? GP
  contribution expected ?)
• Items that will be funded centrally e.g.
  e-booking
• DH has similar list which will be used to assess
  PCT additional funding claims
• Draft guidance available on how PCTs and
  practices should prepare business cases (4.34)

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Service Level Agreements
4.30 IMT services will be delivered to the
practice based on a Service Level Agreement
setting out in detail the responsibilities of the
system suppliers. 4.33 These will be based on a
national template, allow local enhancements and
additions to support future developments, and
ensure that practices will receive higher quality
IMT services whilst preserving choice. 4.38 .
a national template SLA will be developed to
support the development of future primary care IT
systems providing practices with assurances on
training, maintenance and support.

• Draft template SLA developed with Scotland
• Recent input from PCTs
• To be discussed with
• GPC and NHS Confederation
• Local Service Providers
• Suppliers

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NHAIS (Exeter) Changes

• 2003/4
• Quality preparation payment (Oct 2003)
• Uplift to SFA (Oct 2003)
• Seniority payments (Dec 2003)
• 2004/5 (from April 2003)
• Quality preparation payment (last one)
• Global sum
• Minimum Practice Income Guarantee
• Quality and Outcomes Framework Aspiration
• Other payments

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National Quality and Outcomes Framework
Management and Analysis Sub-System
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QMAS Principles

• Not patient based data
• Single national system ensures
• High trust and transparent
• Changes to QOF scheme can be supported
• Payments calculated on a consistent basis for all
  practices
• Single feed to NHAIS payment system
• Practice and PCT access to same information based
  on access rights
• Reduced dependence on individual suppliers
• Value for money
• Pre-populated with IAU data

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QMAS Inputs and Outputs
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QMAS Single Information Source
GP Practice
PCT
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QMAS Implementation Timeline
From Jan/Feb
Aug 2004
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GP Systems 3rd Party Applications

• GP systems
• Only QOF pay components tested certified i.e.
  interface with QMAS
• Suppliers should deliver added value for
  practices (drill down and clinical audit) not
  tested.
• Will not calculate payments
• 3rd Party Applications
• Will not calculate payments
• Can help review and clean data
• Will not be procured nationally
• May form part of a GPSS integrated solution

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Read Codes, Queries and Data Extraction

• DOH GMS contract web site contains
• Logical query specification
• Business rules
• Exception reporting
• PCTs and practices should not develop local codes
  and queries for GMS payments
• National specifications for suppliers to extract
  data from clinical systems to support QMAS

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Training Implementation Support

• NHSIA train NHAIS users
• QMAS CBT training for all users by QMAS supplier
• Option for classroom training for PCTs
• Global Sum payments etc
• Annual Achievement processes
• Implementation managed through QMAS supplier and
  GP system suppliers
• PCT and practice pilots of QMAS before national
  roll out
• QMAS link may be installed in practice systems
  before activation
• Tracking database monitoring

Need local input and involvement
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Legacy Systems GMS Compliance

• Compliance ability of GP system to upload QOF
  data to QMAS
• Practices with non-compliant systems manual
  input

Click on link above to show details of practices
by PCT and SHA and Region
Click on link above to show details of practices
by Supplier and System
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PMS Practices

• IT support via QMAS will be provided for PMS
  practices (using the national quality and
  outcomes framework) to a later timescale

Click on link above to show details of practices
by PCT and SHA and Region
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Practical Steps (nGMS and PMS)

• Make good use of the Quality Information
  Preparation Payment (QUIP DES) and Quality
  Preparation Payment funding
• Set up and maintain disease registers in line
  with good practice guidance
• Improve recording of clinical data using
  preferred clinical codes for the quality and
  outcomes framework
• Review exception reporting
• Improve sharing of clinical data both inside and
  outside primary care

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Other Primary Care Challenges

• Systems support for
• nGMS - essential, additional and enhanced
  services
• PMS
• Alternative providers e.g. voluntary, commercial
  sectors
• Direct PCT provision of care
• PCTs inherit full commissioning responsibility
  for prison health services by April 2006
• Development of Dental Services
• Improved systems integration of e.g. Walk in
  Centres, NHS Direct, Out of Hours
• Improved information for patients
• Better access to patient records

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Questions ?