Transcript Document
Joint LMC /NHS England Finance Workshop 3rd March 2015 Content • Finance issues awareness • Recent contractual changes to GMS/PMS/APMS • Who pays what? • Payment processes • Premises • Guide to Yearend/Legacy issues 2 Raising Awareness • Internal issues- within NHS England’s control e.g. payment omission • Issues driven by external forces e.g. national issues: • • • Glitch on NHAIS/Exeter Technical issues on national systems such as CQRS Central directives 3 NHS England Response • • • • • Send communication out to practices Explanation of causes Impact on Practices Advise practices on corrective actions. Working more closely with FHS teams. 4 Recent Contractual Changes (1) All Contract types – GMS/PMS/APMS Funding increase in core contract: • 238 points reinvested at £5.15 per weighted patient. (see PMS exception) • £1.35 per weighted patient reinvested from Enhanced services. • Inflationary uplift of £0.27 per weighted patient. • Out of Hours deduction revised from 6% to 5.46% of Global sum (£73.56 per weighted patient plus 6% of the London supplement (£2.18 per registered patient). 5 Recent Contractual Changes (2) Funding increase in Enhanced services: 103 QOF points reinvested into Enhanced services comprising: • 100 points into a new ES “Avoiding Unplanned Admissions” • 3 points to increase the tariff for Learning Disabilities from £102.16 to £116 per health check. • Cessation of ‘Improving Patient Online Access’ and Remote Care monitoring on 31st March 2014 to fund core. • Risk Profiling ES now subsumed into Avoiding Unplanned Admissions ES. Reduction in QOF points: • 341 QOF points retired to fund core and ES thereby reducing 900 points to 559 points. Seniority Pay: • Closed to new entrants from 1st April 2014. • To be phased out by March 2020. 6 Recent Contractual Changes (3) GMS only: • The Minimum Practice Income Guarantee (MPIG) being phased out over 7 years hence MPIG decreased by 1/7th in 2014/15 where relevant. • £0.55 per weighted patient reinvested into core funding for GMS practices only. PMS only: • 238 QOF points reinvested in core at £2.93 per weighted patient to take account of PMS QOF points deduction. • NO MORE QOF points deduction. 7 Who pays what? • Primary Care Finance team • • • • • Primary Care commissioning team • • • • Core contract calculations for payments to PMS/APMS practices List size adjustments for PMS/APMS- calculations KPI calculations Adjustments required to premises costs for rent revaluations Directed Enhanced services (DES) Locum re-imbursement QOF achievement and aspiration FHS/PCSS team • • • • Seniority Premises costs (in conjunction with NHS Property Services), including water and business rates PADMs Pensions & levies • Public Health team • All services commissioned by the Public Health department 8 Payment Process (1) Practice Payment Practice Claim Contractual Payment Via CQRS Via CQR Monthly QOF aspiration payment(70%) Annual QOF achievement payment Finance Monthly core contract payment based on April list size List size adjustment payments added quarterly 9 Payment Process (2) Practice Payment Contractual Payment Practice Claim Is it for premises? Practice submits claim directly to FHS/PCSS before last working day of month for payment in following month’s payment run. YES NO Is it for DES? Practice submits claim to Commissioner (may be via CQRS, Open Exeter) in line with DES submission timetable. Commissioner validates and arranges payment in line with DES guidance. YES NO Is it a locum claim? Submit claim following local guidance. YES 10 Premises cost reimbursement Reimbursable costs: • Rent – notional - actual • Business rates • Water • Clinical waste 11 Premises cont’d Rent • Notional • • • • • Rents require completion on CMR1 and CMR2 forms every 3 years Commissioners to instruct District Valuer (DV) Commissioner notifies practice of new valuation and rate Commissioner authorises new rate (arrears/recovery) Quarterly/monthly payments with standard contractual payment • Actual rent Landlord instigates rent review; tenant and landlord agree: rent review memorandum required. Commissioners instruct DV: if rent greater then tenant to pay difference Commissioners authorises new rate - arrears paid Paid quarterly or monthly 12 Year End Guide/Legacy issues • Last day for Commissioners to receive claims information from practices for accrual purposes is 8th April 2015. • Any claims that predate 1st April 2013 should be forwarded to the Central team at • [email protected] 13 Questions ? 14