The new GP contract

Patient engagement event

8 May 2019

Overview GP contracts and local

context

Who we are

• NHS Southwark Clinical Commissioning Group (CCG)

is the statutory body responsible for planning and

buying high quality health services for the 325,000

patients registered with the 35 GP surgeries in

Southwark.

• This includes NHS services like emergency care,

hospital care, community and mental health services,

and GP services.

GP contracts

• Since the NHS was

set up, GP

surgeries have

always been

independent

business which

have contracts with

the NHS to provide

NHS services to

patients.

GP contractsThere are three different kinds of GP contracts:

• General Medical Services (GMS) - nationally agreed

contract introduced in 2003 and which covers running

costs, essential GP services and the Quality and

Outcomes Framework (QoF)

• Personal Medical Services (PMS) - locally agreed

contract where practices receive additional money to

deliver locally focused outcomes or specific services

on top of core contract

• Alternative Medical Provider Services (APMS) – time

limited contracts delivering high quality services

Local context• Of the 35 contracts for GP services in Southwark:

• 2 are GMS contracts

• 27 are PMS contracts

• 6 are APMS contracts

• GP surgeries can also be run by different kinds of

organisations:

• Partnerships of GPs e.g. Villa Street Medical Practice

• Single GPs

• Groups e.g. Concordia, AT Medics etc

• Super partnerships – Nexus Health Group

Overview of the new GP contract

The NHS Long Term Plan (LTP)

• The NHS Long term Plan was published in

January 2019 setting out how the NHS will:

• make sure everyone gets the best start in life

• deliver world class care for major health problems

• support people to age well

• A new GP contract was agreed between NHS

England the British Medical Association (BMA)

January 2019

• It sets out how GP services will help deliver the

vision in the LTP

The NHS Long Term Plan (LTP)

https://www.youtube.com/watch?v=Lh1QJabX7uI

The new GP contractAddresses nine goals, including:

• addressing workload issues

• developing Primary Care Networks (PCN)

• improving Quality and Outcomes Framework

• joining up urgent care services

• using of digital technologies

• delivering new services

• providing more certainty about funding for 5

years

• setting up a new clinical negligence scheme

Primary care networks

https://www.england.nhs.uk/gp/gpfv/redesign/primary-care-networks/

Primary care networks

• Ways of GP surgeries and community services

coming together in a local area to work

together and facilitate shared decision making

• Enables patients and services to benefit from

working at scale

• GP surgeries continue to operate as individual

independent surgeries, not a merger

• Not a legal entity

• Will provide new services

• Share workforce

New services• Enhanced Health Care Homes

• Cardiovascular (CVD) Prevention and

Diagnosis

• Structured Medications Review and

Optimisation

• Anticipatory Care requirements for high need

patients typically experiencing several long

term conditions, jointly with community

services – proactive joined up care

New services• Personalised care to implement the NHS

comprehensive model

• Tackling Neighbourhood Inequalities

• Supporting Early Cancer Diagnosis

• Local services already in place with

federations and/or practices

• New specifications aim to build on this by

creating a set of national minimum

requirements that must be delivered

everywhere

Two PCNs in Southwark

• Proposal to have 2 PCNs in Southwark, one in

the north and one in the south

• Partnership Southwark committed to support

this proposals

• Will support practices to work through 19/20 to

enable the right PCNs in line with the new

service specifications, patient engagement and

system reform in SEL

PCNs in Southwark

• Federations have the expertise in established

organisations which have demonstrated

provider maturity and employ clinical

pharmacists

• Enables Clinical Directors to work in a network

• Structure already in place with contract delivery

for Southwark population through the GP

federations

• 2020/21 developments

North Southwark PCN

1

4

5

6

12

19

2021

2223

18

7

2 3

1 Park Medical Centre

2 Albion Street Group Practice

3 Nexus@Surrey Docks Health Centre

4 Silverlock Medical Centre

5 New Mill Street Surgery

6 Bermondsey Spa Medical Practice

7 Nexus@Bermondsey and Landsdowne

8 Old Kent Road Surgery

9 East Street Surgery

10 Nexus@Aylesbury Health Centre

11 The Villa Street Medical Centre

12 Trafalgar Surgery

13 Nexus@Dun Cow Surgery

14 Nexus@Manor Place

15 Penrose Surgery

16 Maddock Way Surgery

17 Sir Kirk John Close Surgery

18 Nexus@Commercial Way

19 Blackfriars Medical Practice

20 Borough Medical Centre – Dr Sharma

21 Borough Medical Centre – Dr Misra

22 Falmouth Road Group Practice

23 Nexus@Princess Street

Nexus is 1 GP contract but all sites are shown for illustration

139 8

11

1014

15

16

17

South Southwark PCN• 20

• 5 2

3

• Borough21

22

Bermondsey

• 7• 24

23 6 Rotherhithe

• 1

• 9 8 14

• 1511

• 1612 13

• Walworth 2 Walworth 14

1 Concordia Parkside

2 Camberwell Green Medical Practice

3 St Giles Surgery – Begley

4 Hambleden Surgery

5 Forest Hill Group Practice

6 The Gardens Surgery

7 Nunhead Surgery

8 Sternhall Lane Surgery

9 306 Medical Practice

10 Lordship Lane Surgery

11 DMC Chadwick Road

12 Elm Lodge Surgery

13 DMC Crystal Palace Road14 The Acorn & Gaumont House Surgery

15 Queens Road Surgery

16 Dr Aru’s Practice – Lister Primary Care Centre

17 Lister Practice – Lister Primary Care Centre

18 St Giles Surgery – Vasant

19 Melbourne Grove Medical Practice

10

9

13

11

12

4

1415

8

5

6

7

1

18 16 172 3

19

Questions and

answers

GP federations

• GP federations are organisations of GP

surgeries as members working together.

• There are two GP federations in Southwark

and all GP surgeries in Southwark are

members of one

• Quay Health Solutions (a social enterprise)

• north

• Improving Health Limited (a limited company)

• south

GP federations• In Southwark, the GP federations provide the

following services:

• 8 – 8, 7 days a week GP Hubs - Extended Primary

Care Service which provide additional GP/ nurse

appointments

• Population Health Management - delivering

additional local specific services for Southwark

patients including care coordination

• Clinical pharmacist roles – additional clinical

pharmacist post employed for all patients to access

for specific care

Primary Care Networks

• Fantastic opportunity!

• Supports General Practice to take lead role in ’joining up’

services for our patients

• Evidence of much better outcomes when working

together for our populations

Primary Care Networks – Building Blocks

Care Management across Southwark:

• Federation nurses working closely with patients to

identify needs and ensure these needs are met (by

working closely with patients/carers and other agencies)

• Assess health and wellbeing needs

• Actively manage the delivery of support and ensure

needs met

• Working to meet the needs of patients in our populations

across practices

Primary Care Networks – Building Blocks

Pharmacists in GP practices across Southwark:

• Federations bid, on behalf of member practices, for NHS

England program

• Practices prioritised providing development opportunities

and committed to training pharmacists in new role

• Program underpinned by training program

• Improved skill mix in primary care

• Pharmacists working together across practices to

provide care in neighbourhoods / PCNs

Group work

• How will patients and PPGs be involved in the

development of the PCNs?

• What are your views of how patients will benefit

from the new GP Contract?

Next steps

• Timelines

• PCN configuration access model to be

developed

• NHS England engagement new services –

Southwark CCG to engage

• Role of GP practices, federations, PPGs

• Patient engagement event, 4 June 2019

• System reform

• Partnership Southwark