In message <01bd17d4$7af7aec0$LocalHost@ulyssess>, Dr D J Plews
<[log in to unmask]> writes
>I've mentioned before that Rotherham HAs has been working to setting
>practice based budgets, for both fund and non-fundholders. Well, I've had
>some figures through today.
>Each practice has been set a 'target population share', capitation based and
>'weighted'. This includes all hospital referrals, community nurses, etc. I
>am not sure if it includes prescribing, but it looks like it does.
>I hope I've understood the figures properly, but it appears to be only
>possible to compare *total* budgets between practices.
This is an interesting concept - but raises some questions..
Is it purely weighted capitation based? - if so, "expensive" patients
may find it difficult to find a practice able to accept them.
Does it include any element for expensive patients - similar to the
allowances made for fundholders currently? (my understanding, as a non
fundholder, is that the limitation is *not* sufficient to support a
large number of expensive patients - and that there is no provision for
in-year adjustments...)
What about management allowances? Are non-fundholders going to get any?
and if no-one gets a management allowance, are any provisions being made
for possible redundancies of fundholding staff - and from which budget?
Is the time required from the individual practices going to be
reimbursed .. er.. horrible thought .. do you know whether Terms Of
Service are going to be amended to make participation in Commissioning
part of our unfunded duties? ;-<<<<
Is GMS included? and is GMS in Rotherham based on *capitation*,
*historical* or *need* assessments - and if the later, how is need
assessed? In my experience, almost any method results in the underfunded
remaining at the bottom of the pile..;-<<
Above all, what plans are being made for risk management, overspends and
- to be more optomistic about funding levels - "savings"? ;->>
>
>I am nervous of sharing this data with you, even pooled for GPFH v NonGPFH.
>I am at a commissioning meeting next week where it will be discussed and I
>will enquire as the degree of confidentiallity of the data.
I should think most of the actual figures will be regarded as
confidential - but, as I'm also in a locality commissioning pilot, I'd
be very interested in the methodology and outcomes..
>
>Shall we have a poll as to whether list members think GPFH's or Non-GPFH's
>have the biggest "slice of the pie"?????
How devisive!;->> Surely we all feel that everyone should have the same
- but that the pie should be big enough to satisfy everyone!
Mary
>
>
>Dr David J Plews
>==============
>
Mary Hawking Kingsbury Court Surgery Church Street Dunstable LU5 4RS
tel:01582 663218 (surgery)fax:01582 476488 (surgery)
Member of British Healthcare Internet Association
Dunstable and Houghton Regis Locality Commisssioning Pilot
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