Payment Process Within Primary Care Contracting and Finance 30 th January 2015

1Types of Payments and processes 2Payment Timetable Contents

Types of Payments GMS /PMS /APMS contracts Enhanced Services QoF Premises Additional Practice Payments Other - syringes

GMS: Global sum based on weighted capitation - £73.56 Less OOH opt out £4.02 MPIG Payment for some Practices but this is being phased out over 7 years from 1 April 2014 and reinvested in GMS Global sum PMS payments according to contracts agreed- price per capitation varies across Surrey and Sussex APMS contracts generally paid by invoice/ separate arrangements List size adjustments applied quarterly (manually PMS/APMS) Types of Payments : GMS/PMS/ APMS Contracts

Types of Payments : Enhanced Services :DES’s Enhanced Services Payment schedule 2014/15 ServicePayment frequency Payment method CostPayment deadline Available on CQRS Extended HoursQuarterlyPCSS£1.90 per pt n/a PPGAnnualPCSS0.36 per pt n/a Unplanned Admissions Component 1QuarterlyCQRS£1.29 per pt31st July 2014 Component 2QuarterlyCQRS£0.57 per pt 30th November 15 Component 3QuarterlyCQRS£0.29 per pt 28th February 15 Component 4QuarterlyCQRS£0.29 per pt31st May 2015 Component 5QuarterlyCQRS£0.43 per pt31st May 2015 Dementia Component 1 Up front PaymentPCSS£0.37 per pt n/a Component 2Final paymentCQRS/PCSSTBC AlcoholAnnualCQRS£2.38 per count Learning DisabilitiesQuarterlyCQRS £ each count YES

Types of Payments : Enhanced Services Enhanced Services Payment schedule ServicePayment frequency /datePayment method CostAvailable on CQRS Retired Enhanced Services Improving on line Access Second and final payment in June 2014PCSS n/a Remote Care monitoring Second and final payment in July 2014PCSS n/a Risk Profiling and Care management Second and final payment in July 2014PCSS n/a Other Dispensing Quality SchemeAnnual (paid in June/July)PCSS £2.58/ dispensing patientn/a Violent patientsinvoiceSBS n/a

Types of Payments : Enhanced Services Public Health - Enhanced Services ServicePayment method (quarterly) Currently Available on CQRS Seasonal Influenza CQRS Seasonal Pneumococcal CQRS Rotavirus CQRSYES Shingles CQRS MMR CQRSYES Men C Adolescent Claim formn/a Hep B CQRSYES Childrens Influenza CQRS Men C Freshers CQRSYES Pertussis Claim formn/a HPV Claim formn/a Child Pneu (3 vaccs) Claim formn/a Child immunisations:Practices submit data directly to PCSS (paid quarterly)

70% Aspiration payment paid monthly 30% Achievement paid after end financial year (usually June/ July) PMS calculation adjustment: deduction £13,050 for average Practice Practices input data using CQRS Commissioning team review and approve Payment processed by PCSS Types of Payments : QoF

Rent: Notional/ Cost Rents require completion on CMR1 and CMR2 forms every 3 yrs- send form and returned to PCSS PCSS instruct District Valuer (DV) PCSS notifies Surgery of revaluation and calculation of new rate, recovery / arrears (cc commissioner) Monthly payments with standard GMS/ PMS payment Leasehold rents Landlord instigates rent review and tenant and landlord agree: rent review memorandum required. Commissioners instruct DV: if rent greater then tenant to pay difference PCSS instructed by commissioners to calculate for arrears etc and pay new amounts Paid quarterly unless exception (generally a standing order) Types of Payments :Premises Rent, Rates, water and clinical waste

Business rates : Copies of Practice DDRs and their annual/ other invoices to PCSS Generally Reimbursed in line with Practice payment schedule ie (10 mths /12 mths DDRs or annually ) Water rates : Can reimburse on evidence of DDR for the year If paid by BACs- require invoice (original) and proof of payment (bank statements/ BACs or receipt) Clinical Waste: Area team commission contracts directly and process invoices Some PMS (W Sx)Practices were reimbursed monthly estimates with reconciliations at year end but this is being phased out by 31 st March- now requiring original copies plus proof of payment to be submitted to PCSS for reimbursement Types of Payments :Premises Rent, Rates, water and clinical waste

Seniority - paid Quarterly (PCSS ) Practice provides GP details on joining Practice to PCSS Payments cease 31 March 2020,(15% reduction each year) and no new entrants from 1 April 2014 Locums Maternity/ Paternity/ Sickness etc Application form completed by Practices and submitted with relevant certificate of evidence to Primary Care Commissioning team Form forwarded to PCSS (who calculate and make payments) Contact: Laura Fernandez-Keynes (West Sussex) Marian Ryland (East Sussex) Helen Snelling (Surrey ) Types of Payments :Additional Practice Payments/ Other

PADM / Dispensing fees (2 months in arrears) Surgery sends data to PPA (Prescription pricing authority) for processing PPA informs PCSS of payments to make to Practices Note: dispensing drugs are through CCG Syringes : PCSS buy syringes and issue to Practices. Invoices received directly from Supplier and PCSS process charges in NHSE ledger Types of Payments :Additional Practice Payments/ Other

PCSS Monthly Payments Schedule - West Sussex Types of PaymentsPCSS contact Date Claims to be received Date Payment sent Date Payment in Bank Adhoc GMS & PMSLesley/Michael/Chris/David Week 1 Week 1 (up to 10th of a month) PMS Monthly PaymentChris Jarrett4th 4 working days before 15th (nearest working day) Prescribing Drugs Payment GMS & PMSChris Muir 16th (nearest working day) GP Registrars Payment GMS & PMSChris Muir 4 working days before 20th (nearest working day) Ophthalmic PaymentLindsey/Jean 4 working days before 20th (nearest working day) nGMS GP Contract PaymentsChris Jarrett12th 4 working days before 25th (nearest working day) Dispensing Drugs Payment GMS & PMSChris Muir 4 working days before 28th (nearest working day) Payment Timetable