Primary Care Network Workshops Tuesday 2 nd , Wednesday 3 rd and - - PowerPoint PPT Presentation

Primary Care Network Workshops

Tuesday 2nd , Wednesday 3rd and Thursday 4th April 2019

Lunch and Registration 13:00 Welcome 13:30 Primary Care Networks

• What are they?
• What needs to be done.

13:30 Federations how can they support? 14:10 Primary Care and Community Services Integration 14:20 Panel Q&A 14:30 Tea and coffee 15:00 Primary Care Networks space 15:00 Next Steps 16:30 Close 17:00

Agenda

Dr Kiren Collison

Clinical Chair Oxfordshire CCG

Aims for today

1.Background 2.Practical next steps 3.Questions 4.Time with your proposed PCN 5.More questions and discussion 6.Any issues? What further support?

• Don’t panic
• This is a 5 year plan
• CCG and LMC are here to

guide you through it

Context

• The NHS Long Term Plan
• The GP contract reform
• Primary Care Networks

(PCNs) are a key part

Wider

Working with

• ther Health,

Care and 3rd Sectors

Working with other practices

Practice

What is a primary care network?

Local Community of 30,000-50,000

McGovern L, Miller G, Hughes-Cromwick P. Health Policy Brief: The relative contribution of multiple determinants to health outcomes. Health Affairs. 21 August 2014. Available from: http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_123.pdf

The bigger vision

What are PCNs designed to do?

• 1. Use data to design services around the needs of

the population

• 2. Proactive, coordinated care

Prevention Health inequalities

• 3. Connect patients to other services

(e.g. health, care or third sector)

• 4. Support the whole system

Why should we sign up?

• PCNs shown to be successful

elsewhere

• Funding increasingly channelled into

PCNs

• Lose out on funding if opt out
• Greater influence

Potential challenges

• New way of working

Doing a lot for the first time

• Relationships and possible disputes
• Clinical Director responsibilities
• Management and admin capacity
• Data
• Workforce - recruiting, supervising, liabilities, costs
• Legal and tax advice

How are we going to get there?

• ‘Ground-up’ approach
• CCG and LMC to support practices
• Network Contract DES - vehicle

for general practice taking a leading role in every PCN

PCN DES

Workforce Funding 7 specs System

1) Additional roles

• Additionality rule
• New roles added from 20/21
• From 20/21 reimbursable rate calculated based on

weighted population

2) Funding

Practice Support Practice participation (£1.76/weighted pt/year direct to practices) Network Support

• Core PCN funding (£1.50/head for 19/20)
• Clinical Director (£0.51/head for 19/20 then

£0.69/head) Access

• Extended hours DES (£1.099/head for 19/20

then £1.45/head)

• Improved access (GPAF) (~£6/head) from 2021

Investment and Impact Fund

• Further details awaited

And in return…

7 national specifications:

2019 2020 2021

2019 2020 2021

• Extended Hours access

integrated into networks – 100% of network population

• Structured medication

review

• Enhanced health in care

homes

• Anticipatory care (with

community services)

• Personalised care
• Supporting early cancer

diagnosis

• Cardiovascular disease

prevention and diagnosis, through case finding

• Action to tackle

inequalities

Plus…

• Support the system
• Making best use of resources
• Engagement with patients – including

‘seldom heard’

• Additional services based on local need

Tuesday 2 April 2019 Wednesday 3 April 2019 Thursday 4 April 2019

Dr Raman Nijjar Dr Matt Mayer Dr Richard Wood

Chair Oxfordshire LMC Chief Executive Officer Oxfordshire LMC Chief Executive Officer Oxfordshire LMC

Next practical steps

Forming a PCN

• Size
• Restrictions:

– Geographically Contiguous – No doughnuts!

• Nominated Payee

Clinical Director & Governance

• Clinical Director

– Who

• Clinician working within your PCN.
• COIs

– How

• Governing Body

– How are practices represented? – How do you make decisions? – Other concerns

PCN Structure

• Workforce
• Pensions
• VAT
• Contractual liabilities

“We’ll all pitch in”

 Pensions  VAT  CQC ! Liability

“We’d like one of our practices to lead on this”

 Pensions  CQC  Easier for most  Incentive for the keen ! Liability ! VAT

“We’ll ask our federation to do this”

 Liability  Managerial  Easier for most ! ? VAT ! ? Pensions ! ? CQC

“We’ll team up with our local community trust who can help us deliver this”

 Pensions  CQC  Easier for most  Liabilities  Diverse staff ! VAT ! ?GP Autonomy

4.

Network Agreement

• Clauses – sign by 15th May
• Schedules – sign by 30th June

– Schedule 1: Network specifics and meetings – Schedule 2: Additional Terms – Schedule 3: Activities (e.g. KPIs) – Schedule 4: Financial Arrangements – Schedule 5: Workforce – Schedule 6: Insolvency – Schedule 7: Arrangements with organisations outside network

• You need to keep this up-to-date!

Dr Kiren Collison

Clinical Chair Oxfordshire CCG

Timetable for DES introduction

https://www.england.nhs.uk/wp-content/uploads/2019/01/gp-contract-2019.pdf

Developing support

• CCG Locality meetings: discussions at the

January and February meetings

• CCG and the LMC: discussions on the significance
• f the contractual developments
• CCG, GP Federations and Oxford Health:

discussions as potential delivery partners in the PCNs

Ongoing support to PCNs

• PCN workshops
• 3 sessions per practice (£900)
• 1 session per week per PCN (for 10 weeks)

– Early indication of PCNs – Engagement in June integration workshop

• Integration workshops – June tbc
• Integrated multidisciplinary working workshops
• Development of support programme locally and by NHSE
• CCG locality meetings to advance, support and share learning
• FAQs

Tuesday 2 April 2019 Wednesday 3 April 2019 Thursday 4 April 2019

Dr John Harrison Andrew Elphick Helen Shute

Chairman PML Chief Executive Officer PML Chief Executive Officer OxFed

Tuesday 2 April 2019 Wednesday 3 April 2019 Thursday 4 April 2019

Pete McGrane Tehmeena Ajmal

Clinical Director, Community Oxford Health NHS Foundation Trust Lead for Primary & Community Integration Oxford Health NHS Foundation Trust

Panel Questions

Breakout questions

• Who will be chosen as accountable clinical director? Will

the job be shared?

• How will the process take place? By appointment or by

election? How would voting work?

• Who will receive funding on behalf of the PCN?
• How will you decide what goes into your network agreement

(decision-making processes, employment model, accountability)?

• Any issues that need to be resolved before 15th May?

Next steps

By 15 May

• The Names and the ODS codes of the Member

Practices.

• The Network list size, as of 1 January 2019
• A map clearly marking the agreed network area
• The initial Network Agreement
• The single practice or provider that will

receive funding on behalf of the PCN

• The named accountable Clinical Director

Do you need further support?

• Reading to help you:

– GP Contract – BMA Handbook – FAQs

• Contact the LMC ceo@bbolmc.co.uk
• Contact the CCG occg.pcn@nhs.net

• Don’t forget: you can use your partnership

agreement for a lot of the schedules.

• Also, note: CCG-funding for time in lieu

can now be used for legal advice instead. £900 per practice + £3000 per PCN!