abcdefghijkl nGMS Contract Review Sean Neill

Background Introduced in 2004 and consists of two key elements; 1.the Scottish Allocation Formula (SAF) 2.Quality and Outcomes Framework (QoF) In 2004/05 the SAF allocated £340 million to 1050 GP practices for core routine primary care services. Current review began in early 2005 and is expected to be complete by September 2006, for implementation in 2007.

Scottish Allocation Formula The SAF is a weighed capitation formula – the three key weights are; 1.Age/Sex structure of the practice population 2.The socio-economic circumstances of the population 3.Remoteness & Rurality

Age/Sex Update The SAF was designed to shift the focus away from a GP based contract to a multi-disciplinary practice-based contract, but the weight was based on GP only contacts.

Remoteness & Rurality Weight included to compensate GPs for the costs associated with rurality e.g. travel and dis-economies of scale. New weight being developed to look at the unavoidable costs of rurality

Remoteness & Rurality

Socio-economic Weight The current Scottish Allocation Formula (SAF) includes an adjustment weight to reflect the impact that socio-economic factors have on GPs workload The weight is a postcode sector-based measure of population characteristics which adjusts the practice population based on the following indicators: 1.The unemployment rate of the GP practice population, 2.The proportion of elderly people (aged more than 65) in the GP practice population, 3.The standardised mortality rate of the GP practice population (for people aged under 65) and 4.Two or more indicators of deprivation from the Census

Socio-economic Weight In May 2005 the SAF review group proposed that the deprivation weight should be reviewed to ensure all relevant coefficients are included in the weight Practice contacts at the datazone level were regressed for the following factors;

Socio-economic Weight 1.Practice contaProportion of households having two or more indicators of deprivation at the census, 2.Proportion of children with lone parents, (Census) 3.Standardised Limited Long-Standing Illness (SLLI) (ISD) 4.Proportion of households which are single-carer households (Census) 5.Proportion of those pension able age, living alone (Census) 6.Overcrowded accommodation (Census) 7.Proportion of over 75s living alone, (DWP) 8.Proportion of the population aged 65 and over and claiming the Guarantee Pension Credit, (DWP) 9.Proportion of working age population claiming either income-based Job Seekers Allowance or Income Support, (DWP) 10.Number of dependents living in a household receiving a key income benefit. (DWP)

Timescales Agreement reached in mid January on who each of the 3 weights can be adjusted Modelling of the impacts of the proposed changes completed – mid February Document outlining the proposed changes issued for consultation – late February Public consultation February-April Further analysis / amends based on consultation – complete mid August New contracted implemented April 2007.