DES payments to GPs for IM&T work unveiled

Preparation for the National Programme for IT could earn practices £1.33 per patient next year under the new payment scheme for GPs.

Details of the directed enhanced service (DES) for information management and technology, first announced in December, have been released as part of a 219-page guidance document on changes to the nGMS contract from April.

As well as outlining the DES for IM&T, the guidance gives details on new direct enhanced services for C+B, one for practice based commissioning and detailed information on changes to the Quality and Outcomes Framework.

The DES for IM&T is broken down into four parts. The first component, worth 40p per patient registered on 1 April, will be paid to practices that agree a practice plan for preparation for NPfIT with their primary care trust.

The plan must include nomination of a practice lead for Connecting for Health and nomination of a Caldicott Guardian at the practice, as well as an IT training plan for the practice and evidence of compliance with good information governance. The guidance says practices will also be expected to be connected to the N3 network by the end of the directed enhanced service and all practice staff that have access to the computer system must be authenticated and registered with a smartcard.

The guidance also makes a reference to the state of the practice hardware; a clause that could potentially be used to put pressure on GPs to move from one system to another if funding for hardware is in short supply. The guidance states: “Practices are expected to enable the upgrade of the hardware estate to a nationally specified standard as set by Connecting for Health in consultation with the Joint GPC/RCGP IT Committee.”

Component two is the IM&T scheme, worth 44p per patient. This can be claimed by practices when they achieve data accreditation in preparation for the upload of summary records to the spine. The guidance sets out a three-part process for accreditation culminating in a visit by the PCT and focusing on electronic note summarisation. This involves compliance with the RCGP/GPC Good Practice Guidelines and taking part in the PRIMIS+ network.

The guidance says that it does not intend that practices will be finally uploading data to the spine in 2006/7, except during pilots, and that the DES is not intended to cover detailed discussions with patients about their spine data.

Further guidance on the data accreditation process is to be issued by NHS Employers, the GPC and Connecting for Health by the end of March.

Part three of the IM&T DES will be a payment of 27p per registered patient for maintaining and regularly validating patients’ address and use of release one of the electronic prescription service software.

Part four, a payment of 22p per patient, will be paid to practices that migrate to a Connecting for Health accredited server. The guidance says it is not expected that all practices will complete all four parts of the IM&T DES in the next financial year.

The DES on practice-based commissioning, also released this week, has been the subject of dispute with the GPC. The GPC is expected to recommend that practices do not take up the service because of concerns that the savings they make will be used to cover PCT deficits.