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national enhanced service


									Local Enhanced Service Validating Referral Data / Activity Information at GP practice level at Brent tPCT
The desire to become more effective commissioners of secondary care services alongside the introduction of Practice Based Commissioning to all PCTs since 1st April 2005 has engendered an organisational synergy to scrutinise the activity undertaken by Acute Trusts and Community Providers for the population of Brent. The full implementation of Payments by Results (PbR) by 2008 will ensure that the current quality issues with referral data will be resolved, making complete validation possible.

All practices are expected to provide essential and those additional services they are contracted to provide to all their patients. This enhanced service specification outlines the more specialised services to be provided. Practices should still provide the data required in the nGMS/PMS contracts, including all enhanced services activity, for example directed enhanced services, including immunisations, and flu data. The specification of this service is designed to cover the enhanced aspects of general practice, all of which are beyond the scope of essential services. No part of the specification by commission, omission or implication defines or redefines essential or additional services. Participating practices will be provided with a detailed outline of required data returns and associated timetables for each. This will also include the PCT deadlines to practices for provision of activity profiles for practice validation.

The aims of this scheme are as follows: Overall aims:   To enable practices to focus upon the collection of data and data analysis to support the implementation of practice based commissioning plans. To support and enable practices to prepare requested PCT or Department of Health information reports, such as quarterly information regarding disease registers for NSF or LDP purposes.

For the PCT to:  PCT to purchase and support X amount of time from practic e managers/admin staff each year for the recording, collating, validation and delivery of data and information.  Provide participating practices with a comprehensive dataset of all referral activity undertaken for their practice population and hence increase the understanding of
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the healthcare resources consumed by each practice population in the preparation for Practice Based Commissioning. For example, participating practices would be able to audit their dataset to retrieve information on which patients regularly require “emergency admissions”. Provide practices with the tools to enable them to provide weekly referral data based upon appropriate read coding for Choose & Book criteria.

For participating practices to:  Validate in full, all reported Primary Care referrals, including acute and community activity, against practice held records.  Validate Practice List data  Provide weekly referral data based upon appropriate read coding for Choose & Book criteria.  Provide profiling information to support statutory returns such as the Standards for Better Health and Annual Health Check.

Service outline
This Local Enhanced Service will fund the practice validation of data to ensure that:    The practice records all referrals to the acute sector and begins to record community providers on their surgery systems in advance of receiving the activity data from the PCT for validation. The practice receives the correct level of information from the Trust (i.e. timely and comprehensive discharge documents) in order for them to validate the hospital and community provider reported activity as accurate. The practice checks and validates the data provided, provides a comprehensive reason for any associated queries, and returns the updated electronic spreadsheet to a named officer at the PCT within 3 weeks of initial receipt. This will include all commissioning queries that the PCT will take forward on behalf of the practice as well as detailing clinical queries that the Practice have raised with colleagues at the relevant hospital Trust regarding the package of care provided to any of their patients. The practice will be supported with any training required on systems/software where appropriate.


Out of Scope
This LES does cover information requests as outlined above but does not cover PCT requirements for the provision of data and information for one-off requests which fall outside of the work of Practice based Commissioning, e.g. prescribing data. The practice will receive a timetable outlining deadlines for the submission of information as outlined above. Practices should still provide the monitoring data required in the nGMS/PMS contracts, including all enhanced services activity, for example directed enhanced services, including immunisations, and flu data.

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Participating practices must be proficient in the use of Microsoft Exc el and be contactable via email, and must send timely and appropriate reports from their surgery systems. Practices will be expected to participate in any training required to ensure that they can provide the level of detail required by the tPCT.

Contract Monitoring
All practices involved in the scheme are required to meet with authorised officer from the PCT to assess the success of the scheme on a quarterly basis. Participating practices will be expected to meet the response times for recording information on their systems and for sending reports to the tPCT.

All practices that wish to provide this service must complete a minimum level of training in the scrutiny of hospital activity due to the complex terminology and regulations associated with Payment by Results and commissioning of secondary care. This training will be provided by an authorised officer from the PCT, should last no longer than 1 hour and may be delivered to multiple practices at once.

Commencement and Duration
This agreement takes effect from 1st October 2005 (backdated if necessary) and will be reviewed end of March 2006 in line with Practice Based Commissioning plans.

Exit and Suspension Arrangements
Suspension The scheme will be suspended if at any time the practice is unable to provide services in line with the service specification or eligibility criteria. Before any suspension the practice and their cluster lead will discuss the reasons for the suspension, identifying any possible resolution. If the matter is not resolved, the PCT will issue an immediate suspension notice to the practice. Exit Arrangements Either part can provide 4 weeks notice to exit the scheme. Before issuing an exit notice, the parties will meet to discuss the reason for termination. If, after this meeting, the reason for the termination is not resolved, then the relevant party will issue an exit notice.

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Funding time commitment for validation of referral activity at a practice level The PCT will remunerate practices for the time spent undertaking this validation and hence generating queries on the activity reports. The payment for this will be based on the practices list size, as recorded by the PCT on a quarterly basis. The PCT will fund participating practices 60p per patient per year for the validation of the activity that is reported for one calendar month. For example, a practice with 3000 patients will receive £1,800 per year for the validation of activity at a practice level. This equates to £150 per month. Practices will be paid monthly on receipt of their last month’s validated data.

Contact Point The practice should contact the Commissioning Manager, Jamil Choglay, in the first instance regarding any aspect of this LES.

Practice Name Signed on behalf of the practice Designation Date

_______________________________________ _______________________________________ _______________________________________ _______________________________________

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