The General Medical Services (GMS) Contract Wales became effective from 1st April 2004. Delivering Investment in General Practice - Implementing the new GMS contract is the product of negotiations between the General Practitioners Committee Wales (GPC) and Welsh Government. General Medical Services Contract: QOF Statistics. Standard GMS Contract 2006
The General Practitioners Committee Wales (GPCW) represents all general practitioners in Wales and has the autonomy to deal with all matters exclusive to Wales.
Welsh Government - GMS Contract 2021-2022 (December 2021)
BMA GP contract Wales 2020/21
Quality Assurance and Improvement Framework Supplementary Guidance for the GMS Contract Wales 2020/21
GMS letter from Welsh Government 2019 and the GMS Contract via NHS Wales
General Medical Services (GMS) Contract Reform for 2019-20 Welsh Government
GMS Contract web archive
Quality Assurance and Improvement Framework 2019/20
BMA Quality First
Fundamentals of Care Navigation
The GMS Contract agreement for 2021-22 included details for an Access Commitment to be introduced from 1 April 2022 see General practice management | Sub-topic | GOV.WALES ) The Access Commitment requires that care navigation be undertaken for all patients telephoning the practice and when their calls are answered, and where clinically appropriate, patients may be signposted to another appropriate service.
In collaboration with Practice Managers and clinical staff, HEIW has led on the development of a structured e-learning package to support the GMS contract requirements. The eLearning comprises three knowledge and theory modules:
– Fundamentals of Care Navigation
– Skills for Care Navigation
– Care Navigation in Action
The elearning can be worked through on an individual basis; alternatively, it could be used as the basis to group/classroom learning sessions. It should take no longer than 2 hours to complete.
A fourth module is included in the package to encourage and facilitate application of learning in the workplace via a downloadable workbook to guide users in the exploration of their local resources and community assets, and to aid effective signposting. Although not a requirement of the elearning, the workbook is provided to help increase care navigation confidence, skills and performance.To access the elearning directly: Fundamentals of Care Navigation
Background
Investing in General Practice
Pre - 2004, contract paid GPs on the basis of fees and allowances (colloquially known as “the Red Book”). In contrast, the new contract allocated resources to GPs through three main funding streams: the global sum; the Quality and Outcomes Framework (QOF); and enhanced service payments. Separate funding streams were available for practices to modernise their premises and improve their IT infrastructure.
This new contract signalled a significant change with the introduction of a practice based - rather than practitioner based - contract, and an unprecedented scale of investment in general medical services to reward quality of care. LHB's were notified of their primary care allocations in December 2003. The Welsh Government committed this money because it recognised that primary care was an essential part of the program to modernise the NHS.Global Sum was calculated using the Carr-Hill formula based on a number of indices within the practice formula. For some practices, this led to a significant reduction in income streams compared to what they were receiving in the old contract. To avoid practice instability at that time, a correction factor was introduced to bring practice baselines up to the same level of income they received under the “Red Book” contract (the Minimum Practice Income Guarantee). This was designed to be reduced over time on a rising tide of resources which, due to the financial climate, stopped some years later. The Minimum Practice Income Guarantee is being removed over a period of 7 years in Wales commencing 1st April 2015 to reflect the Welsh Government’s commitment to equity of funding for practices.
Enhanced Services can be divided into:
Directed Enhanced Services – these MUST be commissioned by Health Boards and made available to practices (e.g. Mental Health DES, Learning Disability DES etc.)
National Enhanced Services – e.g. anticoagulation national enhanced services
Local Enhanced Services – commissioned and determined by Health Board who may decide to make them available to all practices or just to a specified few.
QOF rewards contractors for the provision of quality care and helps to standardise improvements in the delivery of primary medical services. NICE has been responsible for developing the QOF clinical and health improvement indicators since April 2009. It prepares a menu of indicators for the four UK health departments and the GPC to negotiate as to what changes should be made to QOF. To date this has been negotiated annually.