Dear Colleague
2010 / 11 PBC SUPPORT SCHEME
I am writing to share with you the tPCT’s approach to PBC and quality prescribing for the coming year. This has been agreed through the Joint Commissioning Forum and the Executive Director Team.
For 2010/11 the PBC Incentive Scheme, Prescribing Incentive Scheme and prescribing support have been brought under one scheme, the PBC Support Scheme. The total value of the scheme is £5 per head. In addition the PCT is funding Scriptswitch and a pharmacy intervention scheme as well as continuing to fund the existing pharmacy support teams until the end of July 2010.
As part of the 2010/11 support scheme, the PCT will start to explore the concept of ‘contractualising the gatekeeper role’. The PCT has, in conjunction with alliance prescribing leads, developed 10 Key Prescribing Performance Indicators (KPPIs) which will be circulated in the coming week. To support practices to achieve these,£2 per head will be paid to practices at the beginning of the financial year. The PCT will monitor practice performance against these KPPIs and for every one not met the PCT will take back PBC support scheme funding to the value of 20 pence per head. In addition, attainment against the KPPIs will form the basis of the PCT’s judgment as to whether a practice is meeting its contractual requirements with regard to high quality and cost-effective prescribing.
At the end of the financial year £1 per head will be paid to practices for evidence of genuine engagement with PBC. Further detail about this will be circulated to practices shortly.
Practice and alliance baseline positions (the so-called bottom right hand corner) will be set according to their 09/10 outturn spend in all areas of activity related spend (i.e. where the amount paid under a contract varies with activity). This would only exclude block arrangements and PCT management costs and would be consistent with current PBC arrangements.
Any underspendup to £3 per head of alliance population will already be considered to have been rewarded by the £3 per head payment received by practicesas outlined above. This is in line with the principle of any scheme being at least cost-neutral.
If an alliance underspends its 09/10 outturn by a further 0.5% then an extra £1per head will be paid to the Alliance for distribution. This would be pro-rated for additional savings between 0.0% and 0.5% above the £3 per head.
Similarly, the fifth and final £1 per head will be paid to underspending Alliances if theyunderspends its 09/10 outturn by a further 1% or more above the £3 per head. Once again, this final payment would be pro-rated for savings between 0.5% and 1.0% above the £3 per head.
This should work even for a small, single-handed practice and from a PCT perspective would be slightly better than cost neutral without expecting practices to deliver unachievable levels of savings against 09/10 outturn.
Should the PCT end the 10/11 financial year with a surplus in excess of its control total, then a percentage of that surplus will be paid to the underspent practices of any alliance which has underspent against its baseline. These payments will be in direct proportion to each alliance’s relative contribution to the overall underspend this is still be developed and will be shared with you shortly.
As our Alliance Chair I believe that this approach has had our involvement and would recommend all practices to participate fully.
Yours sincerely,
Version 5 26/3/10