ENFIELD PRIMARY CARE TRUST
Report: Independent sector Contract Primary Care Medical
Date: March 2008
The Board is asked to approve the letting of an Alternative Provider of
Medical Services Contract to Qube Medical Limited for the provision
of primary care medical services for the Ordnance Road Surgery and
Phoenix practices, following completion of tendering.
The APMS Contract has an annual baseline value of £500,000,
equivalent £66 per patient per annum, excluding performance
incentive and QOF payments. The contract duration is three years,
with provision for a two-year extension.
Patient Perspective and Equality impact
The Ordnance Road Surgery and Phoenix practices serve deprived
communities in eastern Enfield. The APMS contract is based on a
high service specification and provides an opportunity to turnaround
these poorly performing practices and improve primary care provision
to the registered patients.
Workforce and Training Impact
Additional primary care medical staff will be recruited in a part of
Enfield classified as under-doctored.
The APMS contract will be monitored through the PCT’s Primary
Care Performance Framework.
The Board is asked to approve the letting of an APMS contract to
Qube Medical Ltd., for the provision of primary care medical services
for the Ordnance Road Surgery and the Phoenix Practice, for a three-
year term, with an annual baseline contract value of £500,000.
Submitted by: Rob Lee, Associate Director Primary Care
INDEPENDENT SECTOR CONTRACT
PRIMARY CARE MEDICAL SERVICES
The Board is asked to approve the letting of an Alternative Provider of Medical
Services Contract to Qube Medical Limited for the provision of primary care
medical services for the Ordnance Road Surgery and Phoenix practices, following
completion of tendering.
In March 2007, EPCT issued a tender notice inviting applications for the
provision of primary care services for four GP practices in eastern Enfield. Two
were new practices to be located within premises in Edmonton; the other two
were existing practices, the Ordnance Road Surgery in Ponders End and the
Phoenix Practice in Edmonton Green, with registered lists of 3,600 and 3,300
respectively. Applicants were invited to submit bids for any number of the
practices or for all four. However, due to the PCT’s financial position, it was
subsequently decided to defer commissioning of the two new practices in
A total of 18 applications were submitted. Six applications were disqualified or
withdrawn during pre qualification assessment. Seven of the remaining 12 were
shortlisted for interview, which was subsequently narrowed down to 2. Of these,
the QML bid demonstrated was considered as demonstrating best value, and the
company was therefore selected as the preferred provider of the two existing
3. Scope of the Contract
The contracted service extends to the provision of primary care medical services
to all patients registered with the Ordnance Road and the Phoenix practices,
including all essential, additional and enhanced services, as defined in the Service
Specification (appended to this report).
The agreement will be an Alternative Provider Medical Services (APMS) contract
that shall run for three years, with provision allowing the possibility of extension
for a further two years.
The contract baseline value is £500,000, equivalent to £66.00 per registered
patient, excluding 10% performance bonus and QOF payments
4. Terms of Business
The terms of business for the contract are summarised below:
The contractor’s indicative income comprises three components; the respective
values of each are described below.
Income Element Estimated Percentage of Total
Based on weighted capitation, adjusted 70%
Based on maximum payment available 10%
Based on achievement of 950+ points 20%
“Indicative Income” represents 100% of expected PCT funding (excluding
payments for services not covered by specification, eg. new enhanced services)
and consists of:
Baseline Contract - Baseline funding is for the provision of essential services to
all registered patients and all elements of the service specification not included in
the performance payments.
Performance Payments - Payments are made based on performance against the
identified services on a sliding scale up to a maximum of £10 per registered
Quality & Outcomes Framework - QOF will be paid in accordance with national
The contract makes provision for a 2% annual uplift for inflation for the three-
(b) Payment Mechanisms
Payments to the contractor through the Exeter system:
Monthly payments include:
Baseline Payment – 1/12th of annual amount
Performance Payments Aspiration – 1/12th of 60% of maximum
QOF Aspiration – 1/12th of 60% of estimated QOF achievement
Reimbursement of Premises expenditure on rent and rates – 1/12th of
Annual payments include:
(c) Performance Framework
In addition to standard regulatory arrangements, the contractual monitoring
regime comprises the following components:
Balanced Scorecard (data set)
The Board is asked to approve the letting of an APMS contract to Qube Medical
Ltd., for the provision of primary care medical services for the Ordnance Road
Surgery and the Phoenix Practice, for a three-year term, with an annual baseline
value of £500,000.