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This week’s podcast features Tim Sacks, Chief Operating Officer at East Leicestershire and Rutland CCG, who guides Ben through the prevalence-based contract they employ for funding general practice in his area. Does it work better than the more traditional, weighted capitation-based models, where are the challenges and can it be employed within a PCN?

Introductions (0:48)

Delegated commissioning (1:33)

GP contracts: weighted capitation versus prevalence (1:48)

How do you implement a new type of contract? (3:16)

Measuring the impact on investment (4:07)

The response from general practice so far (5:31)

How effectively can general practice respond to financial risk? (6:29)

Practice involvement in shaping new contracts (8:08)

PCNs and funding distribution (9:46)

Identifying the fairest and most appropriate funding model (11:38)

‘Proportionate universalism’ (12:38)

Do hybrid models work? (13:58)

Plans for the future (15:17)

Opportunities within a PCN framework (16:27)

Primary care commissioning in the future? (17:33)

The potential for PCNs to own their funding (19:36)

Getting in touch & further information (22:13)

https://eastleicestershireandrutlandccg.nhs.uk/

Tim is contactable via email: tim.sacks@eastleicestershireandrutlandccg.nhs.uk

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James Gransby, Partner at RSM UK and medical financial expert, summarises the key considerations and implications for practices and new networks of their financial arrangements, particularly within the context of the new – and since updated – draft primary care contract service specification.

Introductions (0:48)

James’ initial thoughts on the formation of PCNs and their impact (1:22)

Workforce implications (2:15)

How is the PCN’s money best held? Is there an ‘ideal’ financial model? (3:51)

The lead practice model (5:21)

Lessons learned so far, advice on setting up a new financial model – and all things VAT (6:27)

Let’s talk about pensions (7:41)

Clinical Director pay (9:18)

Check employment status for tax / HMRC (10:04)

Year End accounts (13:00)

Showing a ‘surplus’ and how to manage a PCN ‘surplus’ (14:21)

Impact on practice finances as a result of PCNs (16:15)

Reflecting on the draft service specifications (the December 2019 version) (17:37)

General Practice sustainability in today’s world? (20:10)

James’ top tips for practices and networks (21:55)

Getting in touch (23:10)

The draft GP contract update – new reflections (23:31)

What differences do the changes in the draft contract make? (24:19)

Tax implications for contract incentives? (24:55)

HMRC updates discussed (26:25)

James is contactable at: james.gransby@rsmuk.com

https://www.rsmuk.com/

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Dr Riaz Jetha, GP Organisational and Leadership Development Consultant with Health Integration Partners, joins Ben on this week’s podcast to dissect and discuss the updates to the current GP contract agreement. Listen here for their analysis and interpretation of some of the key amendments and what they mean for primary care and primary care networks on a wider scale.

Introductions (0:09)

First impressions (0:57)

PCN focus (1:29)

Changes to the Additional Roles Reimbursement Scheme (1:50)

Removal of employment liability within the roles reimbursement scheme (3:00)

Which roles will have the most influence? (3:21)

Structuring new roles according to local need (4:48)

Support for PCNs in forming their structures and the funding timetable (5:53)

The impact of the draft service specification updates (7:30)

Changes in the ability to earn (8:40)

Renewing the burden + wider reaction to the service spec changes (9:51)

The Impact & Investment Fund (13:12)

Is the impact and investment funding more lucrative? Could this be a benchmark for the future? (14:46)

Breaking down the investment payments; cost per patient? (16:09)

Changes to imms and vaccs / QOF (16:55)

Increasing GP numbers (17:55)

Access improvement (19:40)

The Time to Care Programme and maintaining positive initiatives (20:39)

Current status of the contract update & draft service specification and Riaz’s final thoughts (21:12)

Riaz is contactable at: riaz.jetha@healthintegrationpartners.co.uk