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Financial Implications of the New Contract Cornwall & Isles of Scilly LMC Conference – 5 February 2013 Luke Bennett
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Financial Implications of the New Contract
Cornwall & Isles of Scilly LMC Conference – 5 February 2013
Luke Bennett
www.francisclark.co.uk
Picture Quiz!
www.francisclark.co.uk
Picture Quiz!
www.francisclark.co.uk
Financial Implications of the New Contract
There are known knowns; these are the things we know we know.
We also know there are known unknowns; that is to say, we know there are some things we do not know.
But there are also unknown unknowns – the ones we don’t know we don’t know.
Donald Rumsfeld – United States Secretary of Defense
The average practice will lose £31,000 of QOF income
Laurence Buckman – Chairman, General Practitioners Committee
www.francisclark.co.uk
Changes from 1 April 2013
1. Quality and Outcomes Framework (QOF)
2. Directed Enhanced Services
3. Local Enhanced Services
4. Uprating of investment to GMS contractors
5. Employer superannuation contributions for locums
6. Employee superannuation contribution rates
www.francisclark.co.uk
Changes from 1 April 2013 QOF points changes
Points per domain 2012/13Domain Points
Clinical 669
Organisational 254
Patient experience 33
Additional services 44
Total 1,000
Points per domain 2013/14Domain Points
Clinical 610
Quality and Productivity 100
Patient experience 33
Public health 157
Total 900
100 points worth about £15,000 37 points shifted to new clinical areas worth about £5,000Raising of thresholds expected to cost £11,000Hence loss to average practice £31,000
www.francisclark.co.uk
Changes from 1 April 2013QOF threshold changes – 2011/12 example
• Contractor index 1.214
• Achievement 250 out of 289 = 86.5%
• Thresholds in 2011/12 40% to 71%
• Points scored out of 17 17
• Disease prevalence 1.209
• Value of points 1.214 x 17 x 1.209 x £130.51 = £3,256.66
CHD6 The percentage of patients with coronary heart disease in whom the blood pressure reading (measured in the previous 15 months) is 150/90 or less.
www.francisclark.co.uk
Changes from 1 April 2013QOF threshold changes – 2013/14 example
• Contractor index 1.214
• Achievement 250 out of 289 = 86.5%
• Thresholds in 2013/14 53% to 93%
• Points scored out of 17 14.24
• Disease prevalence 1.209
• Value of points 1.214 x 14.24 x 1.209 x £133.76 = £2,795.80
• Loss of income £460.85
CHD6 The percentage of patients with coronary heart disease in whom the blood pressure reading (measured in the previous 12 months) is 150/90 or less.
www.francisclark.co.uk
Changes from 1 April 2013
• Directed enhanced services up to £15,000
• Risk profiling and care management for frail older and high risk patients
• Dementia case finding scheme
• Improving on-line patient access to services
• Remote care monitoring for patients with long-term conditions
• Local enhanced services ???
• Kernow Clinical Commissioning Group
• Uprating of investment for GMS contractors 1% ?
• Employer superannuation contribution for locums ???
www.francisclark.co.uk
Changes from 1 April 2013
Employee superannuation contribution rates
Tier Pay range 2012/13 2013/14 Increase
1 Up to £15,278 5.0% 5.0% -
2 £15,279 to £21,175 5.0% 5.3% 0.3%
3 £21,176 to £26,557 6.5% 6.8% 0.3%
4 £26,558 to £48,982 8.0% 9.0% 1.0%
5 £48,982 to £69,931 8.9% 11.3% 2.4%
6 £69,932 to £110,274 9.9% 12.3% 2.4%
7 Over £110,274 10.9% 13.3% 2.4%
www.francisclark.co.uk
Changes from 1 April 2013
Luke’s guess at impact on average practice
£
Changes to QOF
Loss of 100 points (15,000)
New clinical indicators (1,000)
Rising thresholds (6,000)
(22,000)
Earned from new DES 10,000
General pay rise 6,000
Reduction in income for average practice £ (6,000)
www.francisclark.co.uk
Changes from 1 April 2013
Luke’s guess at impact on average full-time GP
£
Reduction in income per GP (2,000)
Tax, NI and superannuation saved 1,091
Increased employee superannuation (2,400)
Tax relief on increased superannuation 960
Reduction in take-home pay £ (2,349)
www.francisclark.co.uk
Changes from 1 April 2014
1. Quality and Outcomes Framework (QOF)
2. Quality Premium
3. Phasing out of MPIG over 7 years
www.francisclark.co.uk
Changes from 1 April 2014
Estimated impact of phasing out MPIG payments
Number of practices
Ch
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www.francisclark.co.uk
Changes from 1 April 2014
1. Quality and Outcomes Framework (QOF)
2. Quality Premium
3. Phasing out of MPIG over 7 years
4. Uprating of investment to GMS contractors
5. Employee superannuation contribution rates
6. Reduction in pension annual and lifetime allowances
www.francisclark.co.uk
Financial Implications of the New Contract
There are known knowns; these are the things we know we know.
We also know there are known unknowns; that is to say, we know there are some things we do not know.
But there are also unknown unknowns – the ones we don’t know we don’t know.
Donald Rumsfeld – United States Secretary of Defense
Luke Bennett – Francis Clark Head of Healthcare
www.francisclark.co.uk
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