1270654491_PRdl_procuring_primary_care_services.ppt

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1270654491_PRdl_procuring_primary_care_services.ppt

  1. 1. Equitable access to primary medical care services 1 Procuring Primary Care Services James Gold Dr Hemal Desai MRCGP Equitable Access Clinical Adviser Commercial Directorate Commercial Directorate
  2. 2. Equitable access to primary medical care services 2 Procuring Primary Care Services • Overview • Clinical Objective & Principles • Commercial Options • Market Management
  3. 3. Equitable access to primary medical care services 3 PCT Procurement Framework • Based on Fairness in Primary Care • Process and Documents in current use • Preferred Bidder stage (County Durham) • Documents updated and refined for EA • Feedback appreciated
  4. 4. Equitable access to primary medical care services 4 Clinical Objective Delivery of high quality clinical services …patient-centred and value for money, primary medical care services, delivered in a safe and effective manner, through a learning environment, which includes the training of doctors and other healthcare professionals
  5. 5. Equitable access to primary medical care services 5 Clinical Principles • Patient-centred services • Safe delivery of services • Effective delivery of services • Delivering services from a learning environment
  6. 6. Equitable access to primary medical care services 6 Commercial Options • Contract: APMS vs nGMS • Alternative = not just GPs • Term: 5yrs vs …. for life • Performance Management • Pricing: Price per Patient • No volume guarantees • Risk Transfer
  7. 7. Equitable access to primary medical care services 7 Market Management • Market – Local – Regional – National • Early engagement • Consistency • Clarity GPs Large IS Third sector NHS Other Bidder
  8. 8. Equitable access to primary medical care services 8 Workshop Affordability Exercise
  9. 9. Equitable access to primary medical care services 9 Background • Pilots – Bids >> bid estimates – Unaffordable/failed bid – Credibility/litigation • FPC – Accurate Estimates
  10. 10. Equitable access to primary medical care services 10 PCT Procurement Handbook Affordability Exercise (Step 3) Objective To define an affordability ceiling and inform SHA for agreement Resource Guide Expertise  Commercial  Financial  Clinical  Workforce Documents  Affordability model  Completed Project Specifications template Time  10 MD Tasks to complete  Confirm clinical specifications from completed Project Specifications Template  Confirm corresponding staffing complement  Establish non-staffing costs  Confirm risk premium to be included  PCT Board sign off on Affordability model  Inform SHA for agreement Outcome Completed Affordability Model
  11. 11. Equitable access to primary medical care services 11 Affordability • Clinical Specification • Staffing Cost • Non-staff costs • Profit Margins • Risk Transfer • Milestone 1 – sign off
  12. 12. Equitable access to primary medical care services 12 Workshop Project Specifications
  13. 13. Equitable access to primary medical care services 13 PCT Procurement Handbook Define Project Specifications (Step 2) Objective To define the project specifications Resource Guide Expertise  Clinical  Commercial  Workforce/IM&T/Estates  Communications  Project Management Documents  Project Specifications Template  Consultation Guidance Time  30 MD Tasks to complete  Identify local needs  Use Project Specification Template to provide framework for developing project specifications  Develop clinical specifications using local clinical input  Develop other project specifications  Populate Project Specifications Template with clinical and other project specifications  Gain approval for completed Project Specifications Template in accordance with governance arrangements  SHA sign-off  Use completed Project Specifications Template to inform the local consultation process Outcomes Completed Project Specifications template
  14. 14. Equitable access to primary medical care services 14 Project Specifications Template • Key step to set the rest of the process • Needs completion at start • Clinical specs require work up front • Other information is important • PCT / SHA sign off required • Consultation outcome should be only reason for changes
  15. 15. Equitable access to primary medical care services 15 Core Criteria GP practices √ Core GP services √ List size of at least 6,000 patients √ Extended opening hours (minimum of 5 hours per week) √ Plan to be a accredited training practice √ Engaged in practice based commissioning √ With extended (and overlapping) practice boundaries GP practices √ Core GP services √ List size of at least 6,000 patients √ Extended opening hours (minimum of 5 hours per week) √ Plan to be a accredited training practice √ Engaged in practice based commissioning √ With extended (and overlapping) practice boundaries Health Centres √ Core GP services √ Easily accessible locations (e.g. reflect commuter needs) √ Open 8am-8pm, 7 days a week √ Bookable GP appointments and walk in services √ Registered and non-registered patients √ GP-led Health Centres √ Core GP services √ Easily accessible locations (e.g. reflect commuter needs) √ Open 8am-8pm, 7 days a week √ Bookable GP appointments and walk in services √ Registered and non-registered patients √ GP-led Local flexibilities will enable PCTs to maximise innovation by integrating and co-locating health centres with other services Local flexibilities will enable PCTs to maximise innovation by integrating and co-locating health centres with other services Diagnostic services Community pathology Radiology Audiology Diagnostic services Community pathology Radiology Audiology Specialist services Minor surgery Dermatology Chronic pain GU medicine Specialist services Minor surgery Dermatology Chronic pain GU medicine Rehabilitation COPD Chronic pain Orthopaedic Stroke care Rehabilitation COPD Chronic pain Orthopaedic Stroke care Pharmacy services Pharmacy services Palliative care/ end of life care Palliative care/ end of life care Urgent out-of- hours care Dental services Urgent out-of- hours care Dental services Social careSocial care
  16. 16. Equitable access to primary medical care services 16 Clinical Specifications • Core GP services – Essential – Additional (except OOH) – Directed Enhanced Services • Variable services – National / Local Enhanced • Catchment area • Mode of access • Details of any decommissioned practices • Project growth of practice (evidence required) • Opening hours • Service commence date
  17. 17. Equitable access to primary medical care services 17 Other Specifications • Commercial – Affordability exercise – Contract duration – Estimated contract value • Premises – Proposed premises solution – Agreements, etc • Workforce – TUPE, etc • Training • IM&T – PCT vs. Provider

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