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nGMS Contract Review

nGMS Contract Review. Sean Neill. Background. Introduced in 2004 and consists of two key elements; the Scottish Allocation Formula (SAF) Quality and Outcomes Framework (QoF) In 2004/05 the SAF allocated £340 million to 1050 GP practices for core routine primary care services.

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nGMS Contract Review

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  1. nGMS Contract Review Sean Neill

  2. Background • Introduced in 2004 and consists of two key elements; • the Scottish Allocation Formula (SAF) • 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.

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

  4. 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.

  5. Remoteness & Rurality • Weight included to compensate GP’s 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

  6. Remoteness & Rurality

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

  8. 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;

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

  10. 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.

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