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Richard Armstrong

Richard Armstrong. Head of Primary Medical Care Contracting Department of Health. Practice-led Commissioning. What is it ? Why Legal Framework Mechanics. Government Policy Themes. Decentralisation STBoP Foundation Trusts Care/Children Trusts Systems Reform nGMS/nPMS

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Richard Armstrong

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  1. Richard Armstrong Head of Primary Medical Care Contracting Department of Health

  2. Practice-led Commissioning What is it ? Why Legal Framework Mechanics

  3. Government Policy Themes Decentralisation • STBoP • Foundation Trusts • Care/Children Trusts • Systems Reform • nGMS/nPMS • Improving Performance • Modernisation Agency/SHAs • CHAI/Star ratings • Improvement Plans

  4. PCTs: The challenges • Delivering the LDP • Access • NSFs • Other National priorities (Health Inequalities, Drugs etc) • System Reform • Choice • Payment by results • Foundation Trusts • Secondary to primary care shift • Contracting for Primary Care provision • Real clinical and public engagement

  5. PCTs: The challenges The real challenge Matching demand with capacity, whilst meeting Need!

  6. Practice-led Commissioning WHY? • Empowering & engaging clinicians • Choice, Access, Payment by Results • Providing clear mechanisms for accountability • Allows innovation – creating plurality of provision • It works

  7. Practice-led Commissioning WHY NOT • Perverse incentives • Distortions and gaming • Transaction costs • Alienating the profession

  8. Practice-led Commissioning • Legal framework • Rights & Responsibilities - Clinical Team - PCT • Down to PCT to determine - scope - range and - form of arrangements • Not complete (or single) answer

  9. Practice-led Commissioning Mechanics • Setting budgets • Historic • Weighted Capitation • Something else • Managing Risk • Over/Under spends • Stop Loss/over time • Monitoring & Feedback mechanisms • Contracting

  10. Primary Medical Care – an update nGMS • 99.8% signed • Getting practices paid • Managing disputes • Superannuation (employers cont) PMS • Quality points • OOHs opt out price • Contract variations PCTMS/APMS • Guidance & Directions

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