3. Contracts and Finance

Introduction 3-4 The GMS contract in England, Scotland, Wales and Northern Ireland 3-4 GMS and PMS 3-5 Advice to readers 3-5 The GP practice main principles and procedures relating to the contract 3-5 Performers 3-5 Providers 3-5 NHS body to be or not to be? 3-6 The practices patients 3-6 Open, full and closed lists 3-6 Personal versus shared list systems 3-7 Patients choice of doctor 3-7 Practice area 3-7 Different sorts of registration 3-8 Registered patients 3-8 Temporary residents 3-8 Immediately necessary treatment 3-9 Patients receiving only contraceptive care 3-9 Assigned patients (allocated patients) 3-9 Private patients 3-10 Dual registration 3-10 Out-of-area patients 3-10 Eligibility for free healthcare 3-11 Patients coming to live in the UK from abroad 3-11 British nationals living abroad 3-11 UK residents going abroad for short periods 3-11 General rules for British patients travelling abroad 3-12 The European Health Insurance Card (EHIC) 3-12 Other reciprocal agreements 3-12 Patients from European Economic Area member states seeking treatment in the UK 3-13 General rules for treatment of overseas visitors to the UK from non-EEA countries 3-13 New patients Contractual obligations and good practice 3-14 Practice leaflets 3-15 Declining to register patients 3-16 Removal of patients from the list by the PCO 3-16 Removal of patients from the list by the practice 3-17 Removal of violent patients 3-18 Difficult situations 3-18 Patients with dental problems 3-18 Ghost patients and green cards 3-19 Consultation obligations 3-19 Doctors availability 3-19 Private services for NHS patients 3-20 Short-term sickness 3-21 Further information 3-22 Notes for school 3-22 Fitness for alternative treatment, fitness programmes, sport, etc. 3-22 Certificates/reports for charities 3-22 Private services related to travel 3-22 Financial entitlements under the nGMS contract April 2004 3-23 Global sum and minimum practice income guarantee 3-23 The Carr-Hill allocation formula 3-26 Agesex adjustments 3-26 Agesex workload index (using males aged 541) for the UK excluding Scotland 3-26 Agesex workload index (using males aged 5141) for Scotland only 3-26 Nursing and residential homes 3-26 List turnover 3-27 Additional needs 3-27 Staff market forces factor (MFF) 3-27 Rurality 3-27 London 3-27 Combining the adjustments 3-28 List inflation 3-28 Future changes 3-28 Minimum practice income guarantee (MPIG) 3-28 Further information 3-28 Essential, additional and enhanced services within the new GMS contract 3-29 Essential services 3-29 Additional services 3-30 Cervical screening 3-30 Maternity services 3-30 Child health surveillance 3-30 Minor surgery 3-31 Contraceptive services 3-31 Vaccinations and immunisations 3-31 Opting out of additional services 3-35 Enhanced services 3-36 Directed enhanced services 3-36 Childhood immunisations 3-37 Payment 3-37 Influenza and pneumococcal immunisations for at risk groups 3-38 Target group for influenza vaccination 3-38 Target group for pneumococcal vaccination 3-38 Setting up a pneumococcal vaccination programme 3-39 Managing your surgerys time 3-39 Opportunistic identification 3-39 Financial benefits 3-40 Minor surgery 3-40 Services to support staff dealing with violent patients 3-41 Payment 3-41 Clinical directed enhanced services for England only 3-41 Extended hours 3-42 Extended opening hours access DES, 201112 3-43 Staffing issues 3-43 National enhanced services 3-43 Local enhanced services 3-53 Further information 3-54 Costs and benefits of implementing new enhanced services3-54 Getting the facts 3-54