PBC NEWS - JULY 2007 UPDATE

Im writing to give you a bit of a heads up on PBC savings

There have already been some Consortium meetings to discuss this and ive tried to explain where things are at. We have also had a meeting with the PCT today to iron out some problems/issues

Overall where are we?

  • Well its actually pretty good news overall – with savings to be paid out of £1.8m, (which the PCT can afford) made up of reductions in A&E attendances of £225k and in first outpatient appointments of nearly 900k. This does demonstrate all your hard work
  • Most consortia have now met and are thinking about the use of savings and split between practice and consortia
  • The good news is that with the pooling of 50% of money with ELIC we will have a significant sum to invest of about 750k

The ELIC pool

The good news is that ELIC is proposing to kick start 4 new LESs

  • Antenatal management (which is such a hot issue locally)
  • Practice based DMARDs
  • COPD
  • Obesity

These LESs will be available to ALL ELIC practices irrespective of whether you’ve made savings or not and they will pay practices for delivering certain things around these areas. We have tentatively agreed with the PCT that we will get them going and that they will transfer over to the PCT to manage and pay for later this year (our decision making is quicker than theirs!)

That means we will be looking at other ideas for spending the ELIC pool

Savings figures

  • Expect a new spreadsheet from the PCT with the final figures!
  • There have been some changes following some queries we made about how unregistered patients had been allocated. This has shifted figures a little for individual practices
  • What the PCT has done in recalculating the figures is fine and reasonable and our steer to you is not to get too hung up on why/how these changes have been made
  • We have asked for some detailed breakdown by practice of the figures behind the headlines. So if you’ve overspent is it due to more activity, a particular hospital, more costly activity or what. We have negotiated that this should be available in the next couple of weeks and we will aim to get some understandable analysis of this to you asap
  • One final thing is that the savings figures are still based on 11 months projected to a full year – there may be some tweaks once final year end figures are finalized but we do not expect these to be significant. This should be available end of July.

Access to savings

There are 3 issues here

  • To access savings you have to pass the primary care performance framework. Details of how you have performed against the framework will come out mid July.
  • The thorny issue of Choose and Book. Following the disquiet expressed at the GP Forum we lobbied the PCT that the way the 40% qualifier has been calculated is seriously flawed and there is not a lot of credibility in this amongst the GP community what with confused targets and mixed messages
  • The PCT has accepted this and the qualifier is now 10% - thus allowing more of you to access savings
  • For those of you who didn’t make savings but achieved your business plan (which everyone did) you are entitled to 95p per patient minimum reward (this is only for practices who don’t get savings! You don’t get it as well as savings)

So what next?

Ive divided this into various categories First of all even though theres uncertainty about final year end figures we should plan on the basis of the figures due out shortly. We can always adjust accordingly later. Don’t wait!

For practices who only can access the 95p DES

  • This will stay with the practice. There is no pooling of 50% of this with ELIC
  • Its practice income and you DON’T need to produce a plan on what you want to spend it on
  • If you have taken out a clinical time loan use it to pay some of this off (I can advise you on this)

For practices who are overspent

  • Sit tight until we have some more analysis available. We will then help you understand this and suggest what to do.
  • Remember you can still take out a clinical time loan of an additional £2 per patient. However as you are overspent I can appreciate you might be cautious on this
  • Be happy to discuss with you

For practices with savings

  • You have received the checklist of ideas for use of savings from ELIC. Please consider this in the context of your Consortium discussions about whether to pool as a Consortium
  • We need to know your ideas on the checklist - download here PBC savings check.doc -(and on any other ideas you might have to spend savings) by 12 July latest
  • We can then write the necessary business cases once we know what you want to do at practice level and what at Consortium
  • As ever ELIC will write these for you!
  • We have to get these plans in by 16 July otherwise they miss the decision making timescales in the PCT machinery
  • So don’t delay deciding what you want to do!!!

Does that all make sense? if not – as ever just ask!!

Paul
July 5 2007