nGMS and PMS Learning Exchange Programme

1. nGMS and PMS Learning Exchange Programme Information and IM&T – The GMS Payments Project January and February 2003

2. Agenda • Background and Context • The Contract – IT Implications • Funding • Ownership • Minimum Functionality Specification and Business Case Guidance • Service Level Agreements • The GMS Payments Project • NHAIS Payments – The Exeter System • QMAS (National QOF Management & Payments System) • Legacy systems and GMS compliance • Suppliers • Training • PMS

3. Background • GMS Payments Project is part of NPfIT • Scope: • Changes to GP systems • Changes to payment systems • Implementation of national QOF system • Training and support for new and changed systems • Project Board (chaired by Chris Town) and working groups • Project Team of NPfIT and NHSIA people

4. Context - NPfIT Aim To deliver a 21st century health service through the efficient use of information technology • Improve quality and convenience of care by ensuring that those who receive care have the right information, at the right time. • Implement projects vital to the NHS modernisation programme using IT to directly improve the patient experience and clinical care.

5. Funding for GP Computer Systems • £20m released to PCTs 05/11/03 • In addition to £50m in existing baselines • Full £70m (ave. £8,000 per practice pa) should be allocated for GP IT before claiming additional funding • 13 SHA s submitted claims for additional funding by 19/12/03 • Deadline extended to 31/12/03 • Claims being assessed to ensure equity and validity • Practices must not be denied funding for core items (DH paper available)

6. Ownership of Systems & Transition Arrangements • Still under discussion with BMA/NHS Confederation • Status quo until there is agreement and guidance is issued 4.30as new money is spent on providing new systems and upgrading existing systems,PCO ownership of the assetand the responsibility of the PCO to provide the full supporting service, including maintenance, future upgrades, paying for running costs of the new integrated systems and training, will be established at the same time.

7. Minimum Functionality Specification & Business Case Guidance • GPC guidance list : • Core items which should normally be fully funded • Non-core items which may be optional (? GP contribution expected ?) • Items that will be funded centrally e.g. e-booking • DH has similar list which will be used to assess PCT additional funding claims • Draft guidance available on how PCTs and practices should prepare “business cases” (4.34) • 4.41Work is continuing to develop a minimum functionality specification for practice systems that defines the information requirements to deliver integrated care and meets the requirements of the new GMS contract.

8. Service Level Agreements 4.30IM&T services will be delivered to the practice based on a Service Level Agreement setting out in detail the responsibilities of the system suppliers. 4.33These will be based on a national template, allow local enhancements and additions to support future developments, and ensure that practices will receive higher quality IM&T services whilst preserving choice. 4.38…. a national template SLA will be developed to support the development of future primary care IT systems providing practices with assurances on training, maintenance and support. • Draft template SLA developed with Scotland • Recent input from PCTs • To be discussed with: • GPC and NHS Confederation • Local Service Providers • Suppliers

9. NHAIS (Exeter) Changes 2003/4 • Quality preparation payment (Oct 2003) • Uplift to SFA (Oct 2003) • Seniority payments (Dec 2003) 2004/5 (from April 2003) • Quality preparation payment (last one) • Global sum • Minimum Practice Income Guarantee • Quality and Outcomes Framework Aspiration • Other payments

10. QMAS National Quality and Outcomes Framework Management and Analysis Sub-System

11. QMAS – Principles • Not patient based data • Single national system ensures: • High trust and transparent • Changes to QOF scheme can be supported • Payments calculated on a consistent basis for all practices • Single feed to NHAIS payment system • Practice and PCT access to same information based on access rights • Reduced dependence on individual suppliers • Value for money • Pre-populated with IAU data

12. Automated GP Practice “Manual” Achievement data from clinical system BACS Payment Other achievement data – web interface QMAS Central Server NHAIS Confirm Achievement Payment Agency PCT QMAS – Inputs and Outputs

13. QMAS Central Server QMAS – Single Information Source GP Practice PCT

14. GP System Commissioned GP System Certified GP System Installed Submit 1st Adhoc Report GP QMAS Logon Practice on White List Report Loaded Practice on Grey List QMAS Implemented CBT, User IDs & passwords issued QMAS CBT issued Grey List Implemented QMAS Implementation Timeline From Jan/Feb Aug 2004

15. GP Systems & 3rd Party Applications • GP systems • Only QOF pay components tested & certified i.e. interface with QMAS • Suppliers should deliver added value for practices (drill down and clinical audit) – not tested. • Will not calculate payments • 3rd Party Applications • Will not calculate payments • Can help review and clean data • Will not be procured nationally • May form part of a GPSS integrated solution

16. Read Codes, Queries and Data Extraction • DOH GMS contract web site contains: • Logical query specification • Business rules • Exception reporting • PCTs and practices should not develop local codes and queries for GMS payments • National specifications for suppliers to extract data from clinical systems to support QMAS

17. Training & Implementation Support • NHSIA train NHAIS users • QMAS CBT training for all users by QMAS supplier • Option for classroom training for PCTs • Global Sum payments etc • Annual Achievement processes • Implementation managed through QMAS supplier and GP system suppliers • PCT and practice pilots of QMAS before national roll out • QMAS link may be installed in practice systems before activation • Tracking database monitoring Need local input and involvement

18. Legacy Systems & GMS Compliance • Compliance = ability of GP system to upload QOF data to QMAS • Practices with non-compliant systems = manual input Click on link above to show details of practices by Supplier and System Click on link above to show details of practices by PCT and SHA and Region

19. PMS Practices • IT support via QMAS will be provided for PMS practices (using the national quality and outcomes framework) to a later timescale Click on link above to show details of practices by PCT and SHA and Region

20. Practical Steps (nGMS and PMS) Make good use of the Quality Information Preparation Payment (QUIP DES) and Quality Preparation Payment funding Set up and maintain disease registers in line with good practice guidance Improve recording of clinical data using preferred clinical codes for the quality and outcomes framework Review exception reporting Improve sharing of clinical data both inside and outside primary care

21. Questions ?