Nicola Cummings is the FPM Regional Representative for Northern Ireland
She is Practice Manager of Banbridge Group Surgery which comprises 3 GP Practices, 12 GPs and has a patient list of almost 20,000. She previously worked for the Out of Hours Service and as a Lay Magistrate. She is currently Chairperson of the local Practice Managers’ Association.
Abortion / Termination of Pregnancy - Northern Ireland (PCS) - New
Child health (Northern Ireland) (PCS) - Revised
Northern Ireland Update - 18th April 2013
GMS Contract 2013/14
NI GP Practices were officially informed on 3rd April that agreement had been reached between NIGPC and DHSSPSNI regarding the 2013/14 GP contract. The key points are:
- 1.5% increase in pay and expenses
- Agreement not to remove MPIG (Minimum Practice Income Guarantee)
- The number of indicators whose thresholds will be increased has reduced from 23 to 13. The domains affected are CHD, diabetes, COPD, BP, stroke and CKD)
- 83 organisational points will be discontinued and the extra funding released by this will be redirected towards GSE (Global Sum Equivalent)
- QOF point value to be increased so that an extra £3.5million will be earned by practices (based on previously projected performance)
It was also agreed that the NI Assembly proposal for mandatory annual health checks would not be carried through and review dates would remain at 12 months.
NIGPC now feel that this agreement enables GPs to engage with Transforming Your Care and GPs are being strongly encouraged to sign up to the NI LES for Integrated Care Partnerships.
Northern Ireland Update - 15th March 2013
GMS Contract 2013/14
In a letter to the NI General Practitioners’ Committee, DHSSPS provided a draft of the proposed, revised statement of Financial Entitlement for 2013/14. The proposed changes include:
- Doctors and Dentists Review Body to make recommendations on uplift
- Deliver “equitable core funding” between GP Practices over a 7 year period, beginning in April 2014; this involves the removal of MPIG correction factor payments
- Introduce the majority of new and replacement clinical indicators into QOF as recommended by NICE
- Raise QOF thresholds; for 22 indicators the lower threshold would increase by 20% while the upper threshold would increase by 5%. These thresholds would increase again in 2014/15.
- Introduce a Public Health domain
- Discontinue QOF Organisational Domain indicators; resources to be channelled into new QOF indicators recommended by NICE
- Any changes to QOF review dates would be dependent on the clinical software suppliers ability to apply different business rules to NI within reasonable timescales and costs
In their letter, DHSSPS emphasised the need for General Practice to be fully committed to and engaged with the delivery of Transforming Your Care. Through QOF, General Practice can help deliver on 2 fronts:
- Reduce hospital admissions and attendances (Quality and Productivity indicators)
- Manage long term conditions (clinical indicators)
The Department state their hope that agreement can be reached with the GPC regarding the proposed changes; however in the absence of any agreement they note their intention to proceed, subject to the outcome of the consultation process which ends on 22 March. A copy of the letter was forwarded to all GP Practices; GPs were urged to review the proposed changes and engage with the consultation process, making their views known to the DHSSPS and their MLAs.
NI Local Enhanced Services (NI LES)
2 new NI LES have recently been offered to Practices:
Demand Management in General Practice
This is described as “a quality improvement programme to manage workload, demand, capacity and responsiveness within primary care”. Practices choosing to provide this service are provided with a self assessment toolkit to enable them to assess both patient demand and practice capacity over a 1 week period. Practices are then tasked with holding a workshop, involving both clinical and non-clinical staff, during which they review the data and make recommendations on how they can better match their capacity to their patient demand. Practices must submit a report by the end of April, detailing 4 proposed areas of improvement which they intend to target during the coming year. Practices receive payment equal to 50p per registered patient as well as a set-up fee and a further fee on submission of the requisite reports.
Integrated Care Partnerships Engagement
As referenced in Transforming Your Care, Integrated Care Partnerships (ICPs) are to be established to help deliver the aims of “high quality and sustainable care whilst ensuring that resources are used as effectively and efficiently as possible”. ICPs’ initial priorities are the frail and elderly as well as respiratory conditions, diabetes and stroke care (FREDS). This NI LES aims to engage practices with the aims of Transforming your Care, identify their position with relation to the FREDS priorities and encourage collaboration between practices and ICPs to plan future care. To fulfil the terms of the service practices must develop a practice based, ICP development plan, including proposals for service redesign as well as management plans for those patients identified as being most at risk. Practices providing this service will receive a fee of 50p per registered patient plus a set-up fee. A further fee will be payable on submission of a practice based improvement plan.
Northern Ireland Update - 28th November 2012
‘Transforming Your Care: Vision to Action’ Public Consultation
‘Transforming Your Care’ was published in December 2011 and is a review of proposed changes in health and social care in Northern Ireland over a 5 year period. Every home in Northern Ireland has been issued with a leaflet containing a personal message from Edwin Poots, Minister for Health, in which he encourages everyone to take part in the public consultation process which is open until 15th January 2013.
Mr Poots states that this review of health and social care in Northern Ireland will result in “a system that allows you to access services nearer to home and to be cared for at home”. He claims “we will shape a healthcare model that is centred on you and is sustainable into the future.”
Further information on the public consultation process can be obtained from www.tycconsultation.hscni.net
Launch of Evaluation Report on Promoting Mental Health and Suicide Prevention amongst Community Networks
On 14th November, Minister for Health, Edwin Poots and Department of Agriculture and Rural Development (DARD) jointly launched this report which focuses on the provision of community based physical and mental health checks to patients living in rural communities. The report was tasked with evaluating the impact of the Northern Area Community Based “Promoting Mental Health and Suicide Prevention Small Grants Scheme” and the Public Health Agency funded Suicide Prevention Development Officers. At the launch Mr Poots stated that “the evaluation findings show that mental health promotion and suicide prevention are being brought right to the heart of local communities” while DARD Minister, Michelle O’Neill, claimed “a key priority for my Department is to address some of the root causes of mental health issues in rural areas such as social isolation and poverty”.
Northern Ireland Update - 19th September 2012
Recent figures show that 95% of 2 year olds in Northern Ireland have received their MMR vaccination; this is a record high.
Healthcare Provision for 2012 Olympic Games NI Training Camps
Medical, dental and pharmacy practitioners provided standby healthcare to teams from around the world during their pre games training in Northern Ireland. Sport NI has reported that the teams were very impressed with and appreciative of the service provided; ten minutes after winning gold, the Chinese gymnastics team telephoned to offer thanks for the support received from our health services.
Pharmaceutical Company Sponsored Initiatives
Health and Social Care Board (HSCB) has published “HSC Board Guidance on Pharmaceutical Company Sponsored Initiatives for Primary Care Practitioners”. The 8 page document addresses the thorny issue of services being provided to GP Practices by pharmaceutical companies including providing a third party eg pharmacist or nurse to carry out work in the surgery. This practice is not encouraged by the HSCB Pharmacy and Medicines Management Team as they believe there to be“significant issues in terms of confidentiality, risk management and clinical governance.” The guidance document outlines the requirement for any GP Practices involved in such joint working arrangements to have an Anti-Bribery policy in place. Appendix 1 of the guidance document is a Proforma for use by GP Practices to ensure that all elements of the decision making process have been completed before proceeding with the venture. It is worth remembering, as outlined in Section 13 of the Proforma that any such support from a pharmaceutical company, if exceeding £100 in value, must be recorded in the Practice’s Gift Register.
Northern Ireland Local Enhanced Services (NI LES)
2012 saw the introduction of NI LES. There are 3 new NI LES which GP Practices can sign up to:
Advanced Care Planning in Nursing and Residential Homes
The aims of this service are to complete a Nursing and Medical Plan for all such patients, identify and assess those with palliative care needs and create an Advanced Care Plan for relevant patients. Practices are provided with a 5 page Nursing and Medical Plan template which should be completed during a face to face meeting at which the patient, Nursing/Residential Home staff and relatives should be present. For those patients who wish to discuss their end of life care and have the capacity to do so, an Advanced Care Plan should be developed, again in conjunction with staff and relatives, using the 3 page template provided. Practices are paid on successful completion of Nursing and Medical Plans; no extra payment is made for Advanced Care Plans.
Complex Co-Morbidity register
Under this NI LES GP Practices will develop a Complex Co-Morbidity Register based on specific co-morbidities as outlined in the specification. Practices should then identify those patients most at risk of hospital admission and develop a Complex Co-Morbidity Care Plan for them. Practices receive a fee for developing the register and for each completed Care Plan. A 5 page Complex Co-Morbidity Care Plan template is provided.
Structured Brief Advice for Alcohol
Alcohol consumption in Northern Ireland is increasing at a greater rate than in the rest of the UK. Under the terms of this NI LES GP Practices are asked to develop a practice protocol for alcohol screening using the AUDIT screening tool. Practices must engage in the opportunistic screening of patients over 18 years of age, who are not seeking treatment for alcohol problems. Specific attention should be paid to those patients at increased risk because of existing physical, mental or social conditions. Depending on the AUDIT score, patients will receive appropriate Structured Brief Advice and review. Practices receive payment for the development of a practice protocol as well as receiving a small payment for each patient screened.