Primary Care Sheffield New GP Contract and Primary Care Networks Andy Hilton , Chief Executive Yvonne Elliott, Deputy CEO

A five year framework for the GP services contract In January 2019 NHS England and the BMA General Practitioners Committee in England published a five-year framework for GP Contract reform to implement The NHS Long Term Plan. The agreement sets out the changes in the 19/20 GMS Contract and joint proposals for reform for the four subsequent years. The Framework sets direction for primary care and seeks to address the core challenges facing general practice. Summary of agreement Addresses workload issues Brings a permanent solution to indemnity costs and coverage Improves the Quality and Outcomes Framework Introduces a new Network Contract DES Helps join-up urgent care services Enables practices and patients to benefit from digital technologies Delivers new services to achieve NHS Long Term Plan commitments Gives five-year funding clarity and certainty for practices Tests future contract changes prior to introduction. 41

Focus for today Clinical Director for PCN networks. 0.25WTE per network. Recruitment process and timetable New Network Contract DES. The Network Contract DES requires all CCGs to have in place 100% coverage from its practices by 1st July. This will be a formal extension of the core contract and all practice populations will need to be represented. Networks to cover 30-50k population size, understand the initial registration process and timetable PCN nominated payee. Understand who will hold the fund for the network New additional roles 2019/20 with clinical pharmacists and social prescribers). Workforce baseline assessment and process for payment Extended Hours provision across PCNs and consideration as to who will provide

The Layers of Primary Care Scale

Network GP Clinical Lead Appoint a Clinical Director for the Network - £0.51 per registered patient Funded at £0.51 per registered patient Understand the requirements and accountability aligned to the role Agree the process for selection e.g. expressions of interest; formal application and interview ; practice vote? Can be shared role within the PCS but not across PCNs Not employed by a commissioner & provided to PCN Doesn’t have to be a GP Provides strategic & clinical leadership to PCN Work with PCN members to improve quality & effectiveness of network services Not solely responsible for service delivery but accountable to PCN members

Network Contract DES registration Complete Registration Form Names & ODS codes of PCN member practices, PCN list size Name of Clinical Director Map showing the geographical area of the PCN Practice or provider that will receive/host PCN funding (must hold a GMS, PMS or APMS contract) Name of the PCN Clinical Director CCGs will confirm approval of PCNs by 31st May 2019

Extended Hours… PCNs must provide extended hours access appointments that equate to 30 minutes per 1000 patients per week, for all registered patients within the PCN This is separate to the CCG-commissioned Extended Access service PCNs will determine how to deliver this as part of the Network agreement Not every individual practice will be require to deliver a particular share of appointments Spec makes reference to “appropriate sub-contracting”

Additional Roles Pharmacist & Social Prescribers 2019/20 Salary 70% reimbursed (social prescribers 100%) Baseline assessment of workforce 31st March ( CCG to co-ordinate) All roles are ‘in addition’ Will be calculated into a weighted capitation sum from 2020 Reimbursement will not be made until people are physically in post and monies claimed by PCNs

Mandated Network Agreement To be completed by 30th June Sets out the structure and administration of the Network and how this will be managed Set of schedules to be locally populated – Schedule 1 by 1st July Mandatory Clauses to be completed Data sharing agreement must be in place to ensure payment and compliance with DES contractual requirements Conflicts of interest Intellectual property Joining/leaving/expulsion from PCN General obligations

In summary…. Recruit your Clinical Director Complete your Network DES Registration form for your PCN Agree your named provider/practice nominated payee Start to think about your additional roles Agree who will deliver Extended Hours and what this means for your PCN Commence work in your PCN on the completion of your full Network Agreement and Schedule 1

PCS Support PCS are here to support PCNs as and when they request this We can be flexible in terms of what support and will respond to each request We have developed a booklet that outlines what this looks like We are happy to come to Neighbourhood specific meetings to help with the next steps (put in specifics based on booklet)

? ? ? Q & A ? ? ? ? ? ? How does the offer fit with your needs as a practice and neighbourhood? Is there anything missing? Any potential concerns or issues?