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Cornwall & Isles of Scilly LMC   Conference – 5 February 2013Luke BennettFinancialImplications of theNew Contract
Picture Quiz!www.francisclark.co.uk
Picture Quiz!www.francisclark.co.uk
Financial Implications of the New Contract   There are known knowns; these are the things we know we know.   We also know ...
Changes from 1 April 2013   1. Quality and Outcomes Framework (QOF)   2. Directed Enhanced Services   3. Local Enhanced Se...
Changes from 1 April 2013QOF points changesPoints per domain 2012/13             Points per domain 2013/14Domain          ...
Changes from 1 April 2013QOF threshold changes – 2011/12 example       CHD6 The percentage of patients with coronary heart...
Changes from 1 April 2013QOF threshold changes – 2013/14 example       CHD6 The percentage of patients with coronary heart...
Changes from 1 April 2013   •       Directed enhanced services                       up to £15,000       •     Risk profil...
Changes from 1 April 2013                Employee superannuation contribution rates           Tier Pay range          2012...
Changes from 1 April 2013                   Luke’s guess at impact on average practice                                    ...
Changes from 1 April 2013             Luke’s guess at impact on average full-time GP                                      ...
Changes from 1 April 2014   1. Quality and Outcomes Framework (QOF)   2. Quality Premium   3. Phasing out of MPIG over 7 y...
Changes from 1 April 2014               Change in income   Estimated impact of phasing out MPIG payments                  ...
Changes from 1 April 2014   1. Quality and Outcomes Framework (QOF)   2. Quality Premium   3. Phasing out of MPIG over 7 y...
Financial Implications of the New Contract   There are known knowns; these are the things we know   we know.   We also kno...
Disclaimer & copyright       (c) copyright Francis Clark LLP, 2013       You shall not copy, make available, retransmit, r...
Luke Bennettluke.bennett@francisclark.co.uk                 01872 276477
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Financial implications of the new contract

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Financial implications of the new contract

  1. 1. Cornwall & Isles of Scilly LMC Conference – 5 February 2013Luke BennettFinancialImplications of theNew Contract
  2. 2. Picture Quiz!www.francisclark.co.uk
  3. 3. Picture Quiz!www.francisclark.co.uk
  4. 4. Financial Implications of the New Contract There are known knowns; these are the things we know we know. We also know there are known unknowns; that is to say, we know there are some things we do not know. But there are also unknown unknowns – the ones we don’t know we don’t know. Donald Rumsfeld – United States Secretary of Defense The average practice will lose £31,000 of QOF income Laurence Buckman – Chairman, General Practitioners Committeewww.francisclark.co.uk
  5. 5. Changes from 1 April 2013 1. Quality and Outcomes Framework (QOF) 2. Directed Enhanced Services 3. Local Enhanced Services 4. Uprating of investment to GMS contractors 5. Employer superannuation contributions for locums 6. Employee superannuation contribution rateswww.francisclark.co.uk
  6. 6. Changes from 1 April 2013QOF points changesPoints per domain 2012/13 Points per domain 2013/14Domain Points Domain PointsClinical 669 Clinical 610Organisational 254 Quality and Productivity 100Patient experience 33 Patient experience 33Additional services 44 Public health 157Total 1,000 Total 900100 points worth about £15,00037 points shifted to new clinical areas worth about £5,000Raising of thresholds expected to cost £11,000Hence loss to average practice £31,000www.francisclark.co.uk
  7. 7. Changes from 1 April 2013QOF threshold changes – 2011/12 example CHD6 The percentage of patients with coronary heart disease in whom the blood pressure reading (measured in the previous 15 months) is 150/90 or less. • Contractor index 1.214 • Achievement 250 out of 289 = 86.5% • Thresholds in 2011/12 40% to 71% • Points scored out of 17 17 • Disease prevalence 1.209 • Value of points 1.214 x 17 x 1.209 x £130.51 = £3,256.66www.francisclark.co.uk
  8. 8. Changes from 1 April 2013QOF threshold changes – 2013/14 example CHD6 The percentage of patients with coronary heart disease in whom the blood pressure reading (measured in the previous 12 months) is 150/90 or less.www.francisclark.co.uk
  9. 9. Changes from 1 April 2013 • Directed enhanced services up to £15,000 • Risk profiling and care management for frail older and high risk patients • Dementia case finding scheme • Improving on-line patient access to services • Remote care monitoring for patients with long-term conditions • Local enhanced services ??? • Kernow Clinical Commissioning Group • Uprating of investment for GMS contractors 1% ? • Employer superannuation contribution for locums ???www.francisclark.co.uk
  10. 10. Changes from 1 April 2013 Employee superannuation contribution rates Tier Pay range 2012/13 2013/14 Increase 1 Up to £15,278 5.0% 5.0% - 2 £15,279 to £21,175 5.0% 5.3% 0.3% 3 £21,176 to £26,557 6.5% 6.8% 0.3% 4 £26,558 to £48,982 8.0% 9.0% 1.0% 5 £48,982 to £69,931 8.9% 11.3% 2.4% 6 £69,932 to £110,274 9.9% 12.3% 2.4% 7 Over £110,274 10.9% 13.3% 2.4%www.francisclark.co.uk
  11. 11. Changes from 1 April 2013 Luke’s guess at impact on average practice £ Changes to QOF Loss of 100 points (15,000) New clinical indicators (1,000) Rising thresholds (6,000) (22,000) Earned from new DES 10,000 General pay rise 6,000 Reduction in income for average practice £ (6,000)www.francisclark.co.uk
  12. 12. Changes from 1 April 2013 Luke’s guess at impact on average full-time GP £ Reduction in income per GP (2,000) Tax, NI and superannuation saved 1,091 Increased employee superannuation (2,400) Tax relief on increased superannuation 960 Reduction in take-home pay £ (2,349)www.francisclark.co.uk
  13. 13. Changes from 1 April 2014 1. Quality and Outcomes Framework (QOF) 2. Quality Premium 3. Phasing out of MPIG over 7 yearswww.francisclark.co.uk
  14. 14. Changes from 1 April 2014 Change in income Estimated impact of phasing out MPIG payments Number of practiceswww.francisclark.co.uk
  15. 15. Changes from 1 April 2014 1. Quality and Outcomes Framework (QOF) 2. Quality Premium 3. Phasing out of MPIG over 7 years 4. Uprating of investment to GMS contractors 5. Employee superannuation contribution rates 6. Reduction in pension annual and lifetime allowanceswww.francisclark.co.uk
  16. 16. Financial Implications of the New Contract There are known knowns; these are the things we know we know. We also know there are known unknowns; that is to say, we know there are some things we do not know. But there are also unknown unknowns – the ones we don’t know we don’t know. Donald Rumsfeld – United States Secretary of Defense Luke Bennett – Francis Clark Head of Healthcarewww.francisclark.co.uk
  17. 17. Disclaimer & copyright (c) copyright Francis Clark LLP, 2013 You shall not copy, make available, retransmit, reproduce, sell, disseminate, separate, licence, distribute, store electronically, publish, broadcast or otherwise circulate either within your business or for public or commercial purposes any of (or any part of) these materials and / or any services provided by Francis Clark LLP in any format whatsoever unless you have obtained prior written consent from Francis Clark LLP to do so and entered into a licence. To the maximum extent permitted by applicable law Francis Clark LLP excludes all representations, warranties and conditions (including, without limitation, the conditions implied by law) in respect of these materials and /or any services provided by Francis Clark LLP. These materials and /or any services provided by Francis Clark LLP are designed solely for the benefit of delegates of Francis Clark LLP. The content of these materials and / or any services provided by Francis Clark LLP does not constitute advice and whilst Francis Clark LLP endeavours to ensure that the materials and / or any services provided by Francis Clark LLP are correct, we do not warrant the completeness or accuracy of the materials and /or any services provided by Francis Clark LLP; nor do we commit to ensuring that these materials and / or any services provided by Francis Clark LLP are up-to-date or error or omission-free. Where indicated, these materials are subject to Crown copyright protection. Re-use of any such Crown copyright-protected material is subject to current law and related regulations on the re-use of Crown copyright extracts in England and Wales. These materials and / or any services provided by Francis Clark LLP are subject to our terms and conditions of business as amended from time to time, a copy of which is available on request. Our liability is limited and to the maximum extent permitted under applicable law Francis Clark LLP will not be liable for any direct, indirect or consequential loss or damage arising in connection with these materials and / or any services provided by Francis Clark LLP, whether arising in tort, contract, or otherwise, including, without limitation, any loss of profit, contracts, business, goodwill, data, income or revenue. Please note however, that our liability for fraud, for death or personal injury caused by our negligence, or for any other liability is not excluded or limited.www.francisclark.co.uk
  18. 18. Luke Bennettluke.bennett@francisclark.co.uk 01872 276477

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