CCG CLINICAL COMMISSIONING LES FOR 2012 - 2013

This page contains the specification for the CCG Clinical Commissioning LES for 2012-2013 with additional documentation to support practices to fulfil the clinical behaviours and encourage consistently good quality referrals in line with our published joint clinical pathways

The CCLES specification has been discussed with practices at recent CCG Clinical Commissioning Forum meetings and approved by the CCGC and is being taken to the ELC Audit Board for final approval.

CCG CCLES 2012 - 2013 Specification and sign-up form:

CCG CCLES Tracker Tool 12 - 13

  • Click here to download the CCLES Tracker Tool: CCLES Tracker 12 - 13 Final version 3.5.12 V6.xls
    • This is an(MS Excel)LES Administration tool based on the content of the updated CCLES specification for 12 - 13
    • Designed for practices to support Consortium Leads, Lead GPs and Practice Managers in tracking practice progress on tasks being completed under the CCLES
    • Progress will be reviewed via each Practices CCLES Tracker by GP Consortium leads at 6 months into the 12 - 13 year for activity completed to that point in time as well as at year end.
    • Use of the CCLES Tracker 12-13 forms part of the supporting evidence for payments and Practices need to keep a supporting evidence on file as agreed with their GP Consortium Leads for all activity
    • The tool also references the activity required to complete the QOF QP Indicators 6 - 14 for 12 - 13
  • NB: please download a copy of the CCLES Tracker (an MS Excel spreadsheet) onto your local PC / network and rename it using the 'save as' option from the 'File' menu. Any data entered onto the on-line version will not be kept!

Discussion with colleagues before referral (optional template codes)

  • Some practices use a READ coded template to record clinical behaviours undertaken in support of the CCLES.
  • If you are interested in using this to code and audit activity via EMIS please click here to download the updated code list to set up your own template: V4 Discussion template codes.doc

QOF QP Indicators (Appendix A): DoH Guidelines for Practices

  • The QOF/ QP Indicators are managed by the PCT via the Direct Commissioning Team, please direct your questions to Alice Benton and her colleagues.
    • The CCG will continue to provide the necessary data sets for QOF/QP indicators to practices (as last year)
    • But as part of QOF, the responsibility for achievement QP indicators lies with each individual GP Practice (and in joint discussion with your Consortium Practices where these tasks require peer review with a minimum of 6 practices).
    • Consortium GP leads are therefore asked to plan discussion/ peer review of practice action plans into the regular consortium meetings (as last year)

A very brief summary of QP / QOF indicators (6 - 14) for 2012-2013

  • QP6, 7 and 8: OPD referral reviews: At least one internal and external peer review of referral activity and costs, with development and adoption of 3 new referral pathways and a final report to the PCT by 31.3.13
  • QP9, 10 and 11: Emergency Admissions: At least one internal and external review peer review of admissions, with development and adoption of 3 care pathways to avoid emergency admissions and a final report to the PCT by 31.3.13
  • QP12,13 and 14: A&E Attends: An internal review of A&E attendances (for quarter 4 of 11/12 data) with a focus on improved access, capability of primary care to treat patients and a peer review of practice plans and a report on progress against this plan to avoid A&E attendances to the PCT by 31.3.13

When the CCG will provide PARR data for CCLES review:

  • Monthly PARR reports will be sent to you by Moz at the intervals below.
  • They represent Patients who are At Risk of Re-admission, based on the PARR Criteria including the last 12 months A&E attendances and admissions to hospital.
  • The first time you receive data for 12 - 13 (mid May for the April 2012 report) it will include all PARR patients.
  • In subsequent months, you will only receive patients newly added to the list to easily identify new additions month by month.
  • These reports are based on activity (SUS) data from Acute Hospitals so there is a resulting delay in the supply of data. Moz will email them to you as follows:
    • The 'April 2012 report' will be sent in mid May 2012 (a total list)
    • The 'May 2012 report' will arrive in mid June 2012 (an update only of patients added to list since the April report was sent to you)
    • The 'June 2012 report' will arrive in mid July 2012
    • The 'July 2011 report' will arrive in mid August 2012 and so on for the remainder of the year.

Sample Care Plan Document for PARR patients

  • GPs need to be involved in care planning as this task involves clinical review and setting out an agreed care plan for these patients.
  • Here is a sample Care Plan Template you may find useful to complete and scan into your GP IT system when reviewing these patients' care: Care Plan Document.doc
  • Please also see the QOF/ QP indicators 9,10 and 11 which link to emergency admissions avoidance via the links above for full details.
    • If you have any queries on the PARR data provision please contact Moz on 020 7683 4191

When the CCG will provide A&E Attendance data for CCLES review:

  • Monthly A&E Attendance reports will be sent to you by Moz at the intervals below.
  • These will list patients who have attended A&E for 5 or more times in the preceeding 12 month period.
  • As these reports are based on Acute hospital (SUS) data, they are not available until 2 months after the end of the month in question
    • So the 'April 2012 report' will be sent to you in June 2012
    • The 'May 2012 report' will arrive in July 2012
    • The 'June 2012 report' will arrive in August 2012
    • The 'July 2011 report' will arrive in September 2012 and so on for the remainder of the year.

When the CCG will provide A&E data for the QP/ QOF review (12,13 and 14)

  • Moz will supply Accident and Emergency data relating to the final quarter of 11/12 (by 31st July 2012 at the latest) for internal review and peer to peer discussion of action plans.
  • As this task relates to QOF QP indicator, please refer to the national guidance via the links above for full details of how practices need to complete the reviews, action plans and reporting to the PCT.
    • If you have any queries on the A&E data provision please contact Moz on 020 7683 4191

When the CCG will provide Quarterly Audit Information (referral/expenditure reports)

  • Practices are expected to enagage in a quarterly review of trends in referral rates / expenditure under PBR Tariff.
  • Please bear in mind acute activity (SUS) data is not available until two months after the end of each quarter hence the intervals below):
  • Moz will email this information to practices at the following intervals
    • Quarter 1: August 2012
    • Quarter 2: November 2012
    • Quarter 3: February 2013
    • Quarter 4: May 2013
  • If you have any queries on the provision of Quarterly Referral data please contact Moz on 020 7683 4191

POLCV Policy 2012 - 2013

  • Please click here to access futher information on the current Procedures Of Limited Clinical Value (POLCV) Policy: POLCV Guidance and IFR team

Resources for CCLES Audits 12-13 and QOF QP Indicator Audits

Resources for Prescribing Audits 12 - 13 (CCLES Audit no:1)

  • For Section 2 Repeat Rx audits: Click here for the standard audit form and instructions: Section 2 Repeat Rx Audit.doc
  • All practices are required to submit their audit to the MMT by 28th September 2012
  • The MMT will look at the results of all audits. If results flag up a need to improve in certain areas the MMT will ask the practice to re-audit and submit the re-audit by 25th January 2013. The MMT hope only a few practices will have to submit a re-audit.
  • For Section 3: Formulary Adherence Audit and Section 4: National Quality Prescribing Indicators: Click here to download the spreadsheet on which you will find both forms for audit submission and reporting to the MMT: Section 3 and Section 4 audit report form for MMT.xls
  • If you have any queries on these prescribing audits, please contact the Medicines Management Team: contact details available via the link below.
  • Please refer to the CCG Prescribing web page for further information on QIPP Prescribing Targets: Prescribing

Resources for Diagnostic Referral Rates Audit (CCLES Audit no:2)

  • To help you with the diagnostic referral rates audit please use the forms below. These are standard CCG Referral Audit Proforma and Audit Reflection Forms
  • Click here to download: Audit proforma 1.doc
  • Click here to download: Audit proforma improving referrals 1.doc
  • Guide to finding patients on Corporate Radar: Guide to CR_v2.pdf
  • Moz will provide practices with diagnostics data with NHS numbers from which you can obtain a minimum of 15 patients to audit per practice. This data will be provided to you by Moz during the week of 9th July 2012
  • Please complete the internal audit in your practice and the Consortium feedback session (with a minimum of 6 practices) by Monday 1st October 2012
  • The GP Consortium Lead to summarise all learning points identified with commissioning and pathway recommendations and to send this report to Dr Gary Marlowe (CCG Planned Care Progamme Board Chair)and Dr Paul Kelland (CCG GP Diagnostics Lead)by Monday 15th October 2012
  • The type of diagnostic tests each Consortium is asked to audit is as follows:
    • KLEAR : US Abdomen
    • WELL: US Abdomen
    • RAINBOW and SUNSHINE: X-Ray Chest
    • NW and NE Hackney: X Ray Chest
    • SW Hackney: US Pelvis

Resources for Mental Health Referral Audits (CCLES Audit no:3)

QOF / QP audit resources for Emergency Admissions

  • Click here for the clinical reflection form for the QP9, 10 and 11 audit of emergency admissions

Emergency Admissions Clinical Reflection Form V2.doc

And finally...

  • If you have any queries on the CCLES or the Audits, please speak to your Consortium GP Lead or call the CCG Offices: Tel: 020 7683 4194 / 4193
  • If you have any queries on the Prescribing audit aspects of the CCLES, please contact the Medicines Management Team of Dr Haren Patel - CCG GP Lead for Prescribing.

Updated: 28th June 2012