Posts Tagged ‘GP’

QOF 2012/13 changes summary

March 16, 2012

QOF guidance 2012-2013 (fifth revision)

As part of the 2012-2013 GMS contract changes, the General Practitioners Committee (GPC) and NHS Employers have agreed a number of changes to the quality and outcomes framework (QOF) effective from 1 April 2012.

The key changes are:

  • the retirement of seven indicators (CHD13, AF4, QP1, QP2, QP3, QP4, QP5) releasing 45 points to fund new and replacement indicators
  • the replacement of seven indicators with eight NICE recommended replacement indicators, focusing on six clinical areas namely Diabetes, Mental Health, Asthma, Depression, Atrial Fibrillation and Smoking
  • the introduction of nine new NICE recommended clinical indicators, including two new clinical areas (Atrial Fibrillation, Smoking, PAD and Osteoporosis)
  • the introduction of three new organisational indicators for improving Quality and Productivity which focus on Accident and Emergency attendances
  • amendments to indicator wording for CHD9, CHD10, CHD14, Stroke12, DM26, DM27, DM28 and DEM3
  • inclusion of telephone reviews for Epilepsy 6

Quality and productivity indicators
The six quality and productivity (QP) indicators covering outpatient referrals and emergency admissions have been agreed for a further year. Three new QP indicators on Accident and Emergency (A&E) attendances have been introduced for one year and are aimed at reducing avoidable A&E attendances. These indicators continue to be aimed at securing a more effective use of NHS resources through improvements in the quality of primary care.

Miscellaneous changes
In addition to the above, a number of other changes have been agreed as follows:

Changes to the points values for the following indicators:

  • BP4 – reduced by eight points to eight points
  • BP5 – reduced by two points to 55 points
  • DM2 – reduced by two points to one point
  • DM22 – reduced by two points to one point
  • CKD2 – reduced by two points to four points
  • Smoking3 (now Smoking5) – reduced by five points to 25 points
  • Smoking4 (now Smoking6) – reduced by five points to 25 points

A number of threshold changes as follows:

  1. raising all lower thresholds for indicators currently 40-90% to 50-90%,
  2. raising all lower thresholds for indicators currently with an upper threshold between 70-85%      to 45%,
  3. a number of upper threshold changes for indicators CHD6, CHD10, PP1, PP2, HF4, STROKE6, STROKE8, DM17, DM31, and COPD10
  4. lower and upper threshold changes for BP5, MH10 and DEM2

ASTHMA3 has been renumbered to ASTHMA10 following a change to the business rules to include a new exception cluster.

DEP4 has been renumbered to DEP6 following a change to the prevalence calculation to apply to all new diagnosis of depression from April 2006.

MH14 has been renumbered to MH19 following a change to the business rules to include an exclusion cluster for patients already diagnosed with CVD.

Records23 has moved into the clinical domain and the supporting business rules have been amended. This indicator is renumbered to Smoking7.

Education1 has been renumbered to Education11 due a change to the indicator wording.

Summary of Allocation of Clinical Domain points

CLINICAL DOMAIN  2012/13 QOF  POINTS

Secondary prevention of coronary heart disease   48

Cardiovascular disease – primary prevention  13

Heart failure 29

Stroke and Transient Ischaemic Attack  22

Hypertension 69

Diabetes mellitus  88

Chronic obstructive pulmonary disease 30

Epilepsy  14

Hypothyroidism  7

Cancer 11

Palliative care 6

Mental health 40

Asthma 45

Dementia 26

Depression 31

Chronic kidney disease 36

Atrial fibrillation 27

Obesity 8

Learning disabilities 7

Smoking 73

Peripheral arterial disease 9

Osteoporosis : secondary prevention of fragility fractures 9

If you have found this informative please visit the  2020 Selection website where you will find many other relevant Factsheets in the Candidates Section

Source: http://www.nhsemployers.org The full QOF guidance is available to download from this site

Are you eligible? Having your documents ready for your job search.

July 7, 2011

Embarking on a search for a new job can be daunting however like all things in life it can go more smoothly with forward planning. This short article is aimed at ensuring you have the relevant factual information at hand. This is important as agencies (like20:20 Selection Ltd) and importantly employers do need to check your legal, employment and academic documentation. Hence if you have all this in order, then when it comes to you being made that perfect job offer the contract/job offer letter is likely to be with you more quickly.

 

The following checklist should help you with your preparation:

  • Passport & Visa (if applicable) – an employer can be fined for employing individuals who are not eligible to work in theUK
  • Driving Licence – you will need the paper and photo card parts. For field based positions you will need a validUKdriving licence with no more than 6 penalty points. It is important you make clear declarations about your driving history when asked as employers will check this with the DVLA.

If you have a nonUKlicence holder and need to convert your licence the following link will give you some guidance:

http://www.direct.gov.uk/en/Motoring/DriverLicensing/DrivingInGbOnAForeignLicence/DG_4022562

  • A recent payslip. This will validated your current basic salary and your National Insurance number. If you are in receipt of other monthly benefits such as a car allowance this will also be verified on the payslip.
  • ABPI certificate – if you have sat and passed the examination you will need to produce your certificate if you are offered employment with a pharmaceutical company. If you have misplaced this, the following link may help

https://extranet.abpi.org.uk/web/abpi/exams.nsf/pages/duplicate_certificate_request

  • Highest education certificates (degree, nursing, A levels etc)
  • For nursing roles you will need your current NMC PIN number and date of expiry. Plus you will also be asked about the date of your last CRB check however your new employer will need to undertake a fresh check.
  • For sales positions you should also put together your ‘Brag File’ or portfolio of successes which should include Sales Data, other performance against KPIs, recent appraisal documents; in fact anything that you can use to sell you and differentiate you in the marketplace.

 

If you are not facing redundancy, timing your job search is also something to consider. For example,

  • We do come across people who may be tied in to car schemes. You are advised to carefully calculate the costs involved to you in walking away from your current agreement, as not all employers offer car opt-out schemes.
  • If you are going to jeopardise any bonus/incentive payments pay by leaving before a certain date.
  • If you have significant holiday commitments it is important you flag these. A job offer may be subject to you attending a training course on a specific date for a fixed time, however discussing these with your Recruitment Consultant early in the process may mean this can be negotiated. Also remember that holiday entitlement will be prorated depending at what stage of the leave year you commence work.

 

At 20:20Selection, we are here to help and guide our candidate along the process. Our specialist team can be contacted on 0845 026 2020 from08:30 – 18:00weekdays.

QIPP

October 21, 2010

FACTSHEET

WHAT IS QIPP?

The QIPP agenda is undoubtedly one of the most significant NHS policies that all organisations who conduct business with the NHS will have to take onboard.

Quality

Innovation

Productivity

Prevention

The agenda will have to run through the every thought and every process that takes place throughout the NHS from Primary Care Trusts to Secondary Care to General Practice.

QIPP will affect every department and individual who works for the NHS – for example front line clinicians, PCT commissioners, estate managers, laundry services, ward staff, ambulance trusts, etc.

Why?

The year 2010/11 is the last year in which the £102 billion that is spent on the NHS is set to get an increase in funding of around 5.5%. For the foreseeable future the growth will be limited to inflation. The NHS needs to identify £15-£20 billion of efficiency savings by the end of 2013/14 that can be reinvested within the service so that it can continue to deliver year on year quality improvements.

HOW WILL QIPP AFFECT PHARMA?

 

In order to do business with the NHS in future, organisations will need to focus on how the products/services that they offer fit in with the local QIPP agenda. Clearly organisations will have to attain immediate overviews as to how the QIPP agenda is going to be adopted at local levels, as it is anticipated that new, complex information resources will be required to deliver tailored solutions for each NHS customer.

PCTs will be looking to move services into primary care to reduce cost and improve Quality and Productivity. Pharmaceutical companies are already working on how to utilise their existing knowledge of World Class Commissioning to drive their targeting and market access strategies – so the platform may already be there, but the message will need refining for the QIPP.

Specifically, some of the areas which the pharmaceutical industry might be concentrating on refining their messages and strategies could include:

  • to reduce preventable hospital admissions resulting from sub-optimal medicines use in chronic medical conditions (e.g. COPD)
  • to identify patients who are currently undiagnosed or misdiagnosed as having a treatable chronic medical condition (e.g. COPD, diabetes, cardiovascular disease)
  • to improve medical adherence and thereby improve health outcomes and reduce waste by reducing levels of non-adherence to medicines (e.g. community pharmacy monitoring schemes, GP staff training)
  • to improve adherence to NICE guidance (e.g. hypertension, DVT prevention)

 

RECOMMENDED EXAMPLES

There have already been some significant improvements made to Quality and Productivity and Department of Health has provided some recommended examples.

Opportunistic screening by pulse palpation of patients over 65 has been used in 18 regions to improve detection of atrial fibrillation. Quality is improved by the optimal treatment of patients with atrial fibrillation reducing risk of stroke. Productivity is increased by the reduction in costs associated with stroke and its complications.

Ten pilot trusts have succesfully implemented service re-design for the Fractured Neck Femur patient pathway. This improved quality by: improving multi discplinary and cross agency teamworking, reducing mortality, and time to theatre, and earlier mobilisation. Productivity was improved by reduced length of stay, readmissions, and delays to the theatre.

The NHS Institute supported Chief Executives and senior leadership to champion change and improvement across NHS organisations in all areas of the stroke pathway. Quality was improved by reducing mortality, time in A&E, and delay in CT scanning. Productivity was increased through reduction in length of stay and readmission.

The NHS Institute has supported ward leaders and nursing teams with innovative methods to improve the ward environment and process. Over 60% of NHS Acute Trusts are implementing the Productive Ward programme. Key improvements from the programme include improved quality through increasing direct patient care time and staff satisfaction and improved productivity through reduced staff absence and reduced length of hospital stay.

Oxford Radcliffe Hospitals have successfully implemented an electronic blood transfusion system. This has improved quality by reducing transfusion errors and the time taken to deliver blood. Productivity has improved by reduced blood usage, wastage, and staff time.

Enhanced recovery programmes use evidence based interventions to improve pre-, intra-, and postoperative care. They have enabled early recovery, discharge from hospital, and more rapid return to normal activities. Quality is increased by reducing complications and enabling a more rapid return to function. Productivity is improved by reducing hospital stay.

To improve the uptake of QIPP by clinicians the Department of Health has published a guide entitled:  The NHS Quality, Innovation, Productivity and Prevention Challenge: an introduction for clinicians www.somaxa.com/docs/file/QIPP_2010.pdf

Further information on QIPP can be found at:

www.link-gov.org/content/view/463/188/

www.library.nhs.uk/qipp/

 

Health White Paper

August 5, 2010
 

LANSLEY’S HEALTH REFORMS

Tuesday 13th July 2010

The new Health Minister announced the White Paper that lays out the future of the NHS over the course of this parliament (which is now a guaranteed 5 years).  He described this as a ‘blueprint’ for Health Policy up to the next General Election.  The main aim is to cut £20bn from the Health Budget over the next 4 years.  One of the main issues is the end of the current PCTs, which means that GPs will have direct control of the commissioning of services.  NHS Management costs are set to reduce by 45% as a part of this reduction.

This is considered by many to be the most radical NHS White Paper to date, and is expected to be well received by the Conservative back benches.  As for the Lib Dems, they had the abolition of StHAs as part of their 2010 manifesto, so this should sit well with them also.

Lansley said ‘the provision of healthcare service will be led by patients and professionals and not by politicians’.

The basics of the White Paper are set out below:

 More power to GPs

The most contentious issues will be the compulsory devolvement of huge commissioning powers to GP and GP Consortia and the abolition of Primary Care Trusts (PCTs). None of this was proposed by the Conservatives when they were in opposition.  These decisions emerged after the General Election. There is concern that a large number of GPs do not want to take on commissioning functions, and in fact are ill-equipped to do so.

It is interesting therefore to note that the British Medical Association has welcomed today’s announcement.

More power to patients

The Government is going to launch HealthWatch England, a new ‘consumer champion’, which will sit within the Care Quality Commission (CQC). The White Paper provides an ethos for structural change; the NHS must be patient led and choices must be led by those at the frontline of delivering those services to patients, i.e. clinicians. On a national level, it will be able to propose CQC investigations of poor service. This organisation will help to strengthen the patient voice and ensure that patient feedback is heard at a local level. Patients will not only have power over the choice of GP they would like to attend (regardless of where they live), but will also have power over who has sight of their patient record.

Abolition of Primary Care Trusts (PCTs)

The complete removal of PCTs, instead of simply reducing their numbers, came as a big surprise when compared to the proposals contained in the Conservative manifesto from January 2010. However, it is in keeping with current measures when you look at the plan to reduce admin costs by 45%.  Some form of supervisory role is of course required, particularly in respect of GPs and other primary care services, and it is a role which Monitor (the body currently responsible for the regulation of Foundation Trusts) may find challenging.   

Abolition of Strategic Health Authorities (SHAs)

SHAs will be abolished as early as  2012. Their functions will be taken over by Monitor. Monitors’ remit will extend to establish it as the key economic regulator in healthcare.

Foundation Trusts

All NHS Trusts will become or be part of a Foundation Trust and this will be the preferred governance model for the health service. Trusts will be given more freedom to innovate to improve patient care. NHS staff will have the opportunity – where appropriate – to manage these organisations as ‘the largest social enterprise sector in the world’.

NHS Commissioning Board

A review of existing quangos is due to report in the autumn but the White Paper makes provision for a number of new bodies which will help implement this new, patient led vision of the NHS. The most vital is the NHS Commissioning Board which will act to ensure quality in commissioning and be responsible for commissioning certain services, such as community pharmacy, which GPs cannot commission. It will also be responsible for increasing patient choice through helping patients manage their personal health budgets. The intention is for this body to be fully operational in April 2012. The underpinning concept is to reduce the number of quangos but those that do exist will be interlinked and more accessible to patients.

Value based pricing

The White Paper confirms that the Government intends to move to value based pricing when the current Pharmaceutical Price Regulation Scheme (PPRS) runs out at the end of 2013. A reference is made to the Cancer Drugs Fund, which will operate from April 2011, but no further details are provided.

NICE

In a further strengthening of its powers, NICE will be in charge of developing new quality standards for all the main pathways of care. The paper estimates that NICE will develop up to 150 new quality standards over the next five years. This will position NICE as the key quality regulator building on Lord Darzi’s work on quality improvements, under the previous Government.

 Scrapping targets

As mentioned in the NHS Operating Framework, targets with ‘no clinical justification’ will be scrapped (although not as many as were discussed in Opposition). There is a concession that some targets do work but the paper is not clear on which ones and a consultation is promised on new measureables.

Long Term Care

A Commission will be set up to look into long-term care from the Department of Health. This is in keeping with the move to strip away the Department’s NHS functions and replace them with longer term social care objectives.

Consultation

A number of consultation papers will be published in the near future, getting stakeholder views on policies including; commissioning for patients, freeing providers and economic regulation, the NHS outcomes framework, the framework for transition. This process will be an important part of the transition to the new system as will the proper management of the financial risk.

Legislation

Primary legislation will be required to make many of the proposed changes in the White Paper. The Health Bill announced in the Queen’s Speech provides for many of these reforms and is due to be introduced in late 2010. The main legislative reforms in the Bill will include: Making improvement in outcomes central to the NHS; Reforming NICE;  creating the independent NHS Commissioning Board; creating a framework for a comprehensive system of GP consortia; establishing HealthWatch; reforming the Foundation Trust model; developing Monitor’s role and reducing the number of arms length bodies in health. The Department of Health is taking comments on implementing all the changes in the Health Bill, which must be submitted by 5 October 2010. We can therefore deduce that the Health Bill will not be laid before Parliament before this date.  

The Health Bill will also support the creation of a new Public Health Service, which will streamline existing health improvement and protection bodies. Another White Paper, this time on public health will be published later this year. In addition, the public health budget will be ring-fenced and local Directors of Public Health will be responsible for health improvement funds allocated according to local need.

Sources: white paper and Mr Lansleys press release.

Nurse Advisor and similar roles within the Pharmaceutical Industry

July 20, 2009

(more…)