Slide1: Procuring Primary Care Services James Gold Dr Hemal Desai MRCGP Equitable Access Clinical Adviser Commercial Directorate Commercial Directorate


Procuring Primary Care Services: Procuring Primary Care Services Overview Clinical Objective & Principles Commercial Options Market Management


PCT Procurement Framework: PCT Procurement Framework Based on Fairness in Primary Care Process and Documents in current use Preferred Bidder stage (County Durham) Documents updated and refined for EA Feedback appreciated


Clinical Objective: Clinical Objective Delivery of high quality clinical services …patient-centred and value for money, primary medical care services, delivered in a safe and effective manner, through a learning environment, which includes the training of doctors and other healthcare professionals


Clinical Principles: Clinical Principles Patient-centred services Safe delivery of services Effective delivery of services Delivering services from a learning environment


Commercial Options: Commercial Options Contract: APMS vs nGMS Alternative = not just GPs Term: 5yrs vs …. for life Performance Management Pricing: Price per Patient No volume guarantees Risk Transfer


Market Management: Market Management Market Local Regional National Early engagement Consistency Clarity


Workshop: Workshop Affordability Exercise


Slide9: Background Pilots Bids >> bid estimates Unaffordable/failed bid Credibility/litigation FPC Accurate Estimates


Slide10: PCT Procurement Handbook


Affordability: Affordability Clinical Specification Staffing Cost Non-staff costs Profit Margins Risk Transfer Milestone 1 – sign off


Slide12: Workshop Project Specifications


PCT Procurement Handbook: PCT Procurement Handbook


Project Specifications Template: Project Specifications Template Key step to set the rest of the process Needs completion at start Clinical specs require work up front Other information is important PCT / SHA sign off required Consultation outcome should be only reason for changes


Core Criteria: Core Criteria GP practices Core GP services List size of at least 6,000 patients Extended opening hours (minimum of 5 hours per week) Plan to be a accredited training practice Engaged in practice based commissioning With extended (and overlapping) practice boundaries Health Centres Core GP services Easily accessible locations (e.g. reflect commuter needs) Open 8am-8pm, 7 days a week Bookable GP appointments and walk in services Registered and non-registered patients GP-led Local flexibilities will enable PCTs to maximise innovation by integrating and co-locating health centres with other services Diagnostic services Community pathology Radiology Audiology Specialist services Minor surgery Dermatology Chronic pain GU medicine Rehabilitation COPD Chronic pain Orthopaedic Stroke care Pharmacy services Palliative care/ end of life care Urgent out-of-hours care Dental services Social care


Clinical Specifications: Clinical Specifications Core GP services Essential Additional (except OOH) Directed Enhanced Services Variable services National / Local Enhanced Catchment area Mode of access Details of any decommissioned practices Project growth of practice (evidence required) Opening hours Service commence date


Other Specifications: Other Specifications Commercial Affordability exercise Contract duration Estimated contract value Premises Proposed premises solution Agreements, etc Workforce TUPE, etc Training IM&T PCT vs. Provider