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Primary Care Contracting Workshop

Primary Care Contracting Workshop. 4 October 2006 WELCOME Jen Dibb-Fuller Primary Care Contracting Advisor – South Central. Introduction PCC – the team Contracting Routes Provider Models Barriers and Opportunities Summary. Introduction PMS/GMS contracts Pharmacy Dental

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Primary Care Contracting Workshop

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  1. Primary Care Contracting Workshop 4 October 2006 WELCOME Jen Dibb-Fuller Primary Care Contracting Advisor – South Central

  2. Introduction PCC – the team Contracting Routes Provider Models Barriers and Opportunities Summary

  3. Introduction • PMS/GMS contracts • Pharmacy • Dental • Practice Based Commissioning • Optometric

  4. PCC team • Advisors • Events – national/local • Communications • Website – new@pcc.nhs.uk • Helpdesk

  5. Primary medical care contracting routes • APMS • PMS including SPMS • GMS • PCTMS • Dental/Community Pharmacy/Optometric

  6. Alternative Providers Medical Services (APMS) Any Person egg • Commercial providers • Voluntary sector • Not-for profit organisations • NHS trusts and foundation trusts • Other PCTs

  7. Personal Medical Services (PMS) • Practices (single-handers, partnerships or a certain type of limited company) • Nurses and other clinicians • PCTs

  8. Specialist PMS • GMS Regulations require provision of essential services • PMS Regulations do not require provision of essential services • APMS contracts without essential services or • PMS contracts without essential services (SPMS) • Allows for contracts with organisations solely for the provision of enhanced services • Disease-specific or locality services • Secondary care type services • Community services

  9. General Medical Services (GMS) • Practices with at least one GP provider (single-handers, partnerships, or a certain type of limited company)

  10. PCT Medical Services – PCTMS • PCTs

  11. Other primary care contracts • Dental • GDS • PDS • Orthodontic • PCTDS • Community Pharmacy • Optometric

  12. Commissioning Strategy Whole systems approach • Commissioning strategy must cover the full range of services • Key area is boundary between primary and secondary care – enhanced services • Focus on commissioning services not contractual form • Secure best provider for the job • Contractual form may depend on organisational structure of contractor • Whatever the service and whoever the provider, there is a contractual form that fits!

  13. Commissioning flexibilities • Structures • Commissioning structures are not prescribed; fit for purpose • Open market for providers of primary care • Processes • Commissioning – do what works! • Procurement – open competition to deliver best value • Contracting – range of options

  14. Procurement • Medical services are classified as Residual B services under the Public Contracts Regulations 2006 • Full statutory procurement procedures do not apply, but: • Must adhere to principles of equality of treatment, transparency and non-discrimination • Must be sufficiently well-advertised to ensure open competition and • Placement of an award notice in OJEC once contract has been placed • PCTs must also comply with their own internal standing financial orders and standing financial instructions

  15. Organisational Forms • Social Enterprise • Limited Company • Limited Liability Partnership • General Practice Partnership

  16. Social Enterprise (Community Interest Cos) • Can be Ltd by shares, guarantee or Public Ltd Co • Restricted from distributing profits and assets to members • Community interest test • www.dti.gov.uk/cics

  17. Limited Company (and Public LC) • Liability limited to members share capital or amounts unpaid on shares • Profit divided according to share holding • Limited borrowing potential • Must be floated by members own capital

  18. Limited Liability Partnership • Separate legal personality • Unlimited capacity • No directors or shareholders not subject to company law rule on capital • Members have limited liability • Flexible internal structure

  19. General Practice Partnership • Share profits or losses –manage business • Agreement • Who • Partner’s rights • Liability

  20. Barriers and Opportunities What do you see are the issues for new providers wanting to come into the primary care market?

  21. Practice Based Commissioning • Engage with community to develop PBC plans • Develop proposals for service and clinical pathway redesign • Provide indicative budgets, clinical and mgt information, analysis of population needs and comparative data • Governance • Agree PBC business plans • DES – incentive schemes

  22. Questions? Jen.dibb-fuller@pcc.nhs.uk www.pcc.nhs.uk

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