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PC why commission

The CCG will co-commission primary care, using the PMS premium and other funding streams to:

  • Ensure a core, consistent offer is delivered to the population of South Worcestershire

  • Deliver the best outcomes for our population

  • Build upon and improve the quality of primary care in South Worcestershire

  • Provide the catalyst for general practice working at scale

  • Promote innovation in how care is delivered, eg working towards a model of multi-specialty community provider(s)

  • Deliver our strategic ambitions for primary care namely:

    Excellent, person centred  Long Term Conditions Care
    Accessible care which is responsive and timely
    Proactive and co-ordinated care, GP patient continuity for the most vulnerable

  • Implement place based commissioning – ending the fragmented commissioning of primary care services

  • Provide a single, clear, transparent and fair funding stream

  • A more collaborative approach to designing local solutions for workforce, premises and IM&T challenges

  • Align contracts and incentives across all providers.

We will also explore the creation of a primary care development budget, funded by one off quality premium achievements and payments. This resource will be available to support the delivery of new ways of working.

The New Primary Care Offer – “Outcomes Based Commissioning” 

At the time of writing it would appear that the expected take up of the NHSE Area Team offer to PMS practices of a 5 year transition period upon return to a GMS contract, removes a level of flexibility that the CCG might have otherwise have had as part of its commissioning armoury. Practices will retain their existing GMS contract and be offered the opportunity to provide a number of quality improvement schemes and services, outside of core, via a local QOF ‘Plus’ an APMS contract (as modified this year by Capsticks) or a Local Improvement Scheme.

Our new, outcomes based commissioning will focus primarily on a set number of critical broad outcomes, key performance indicators with minimum output measures – See fig 2.  These will be identified through a process of co-production with patients, practices and other stakeholders.

PC intentions and structure
Fig 2 - Primary Care Co-Commissioning Intentions and Governance Structure
The CCG ambition is that the following areas be translated into a contract:
  • Proactive, coordinated care for frail and elderly

  • Best Care – Hypertension, CHD, Asthma, Stroke, Dementia, Atrial Fibrillation

  • National priorities eg,  Mental Health, Dementia, Learning Disabilities

  • Effective use of resources

  • Improved access

  • Health Improvement (ie immunisations and screening)

  • Anticoagulation service at scale

  • Quality Referrals

  • Best practice prescribing

The CCG intends to enhance and consolidate the funding available to support transformation of the Primary Care Landscape. The rules surrounding the use of the PMS Premium are clearly set out – this funding cannot be used for anything already funded within the core GMS contract but may be used to commission primary care services which “wrap around” and support general practice eg district nursing, community pharmacy

The 15/16 Primary Care “pot” is likely to comprise of funding from:

  • PMS Premium

  • Unplanned Admissions DES

  • Decommissioned Local Enhanced Services

  • QSP Funding

Our aspiration is to develop and integrate the equivalent of a local QOF Plus into this commissioning and contracting model.  Existing QOF spend will also be re-invested into primary care in the fullness of time.