There are a number of sources of information that may be relevant in the context of managing and monitoring contractors and the provision of services that they are responsible for. They are set out below: Table 1: Information sources Key sources of data and information Other optional sources of data and information which may provide additional context Quality outcomes framework (QOF) General practice high level indicator set Practice profile Practice declaration Financial systems Prescribing data Referrals Clinical governance systems IT control Visits to the practice (QOF / CQC) Serious untoward incident (SUI) Referral and out of hours (OOHs) data Infection control Public health targets Complaints and other PALS information Employment law and workforce Clinical audit HR policies Whistle blowing Patient experience Accident & Emergency (A&E) data Expected health outcomes Controlled drugs Safeguarding Children Good information governance (Information security management: NHS codes of practice and Records management: NHS codes of practice) is essential. AT PMC managers should have a practice file where all relevant sources of information are kept. For example, the file may include all relevant correspondence and notes of any meeting held with the contractor. 2. Early warning and support In many cases, the best opportunity to address concerns successfully is if potential problems are identified early. The process for recognition
The following lists some of the provisions that can be breached regarding PMS and GMS contracts. This is not definitive, but gives an idea of the range and varying severity of breaches that can occur. Breach NHS (General Medical Services Contract) Regulations 2004 Standard GMS contract NHS (Personal Medical Services Agreements) Regulations 2004 Failure to provide essential contracted services Various. Eg Regulation 15 Clause 46 Various. Eg Schedule 5 paragraph 1 Premises are not suitable for the delivery of services Schedule 6 paragraph 1 Clause 27 Schedule 5 paragraph 2 Inappropriate storage of vaccines Schedule 6paragraph 8 Clause 40 Schedule 5 paragraph 6 Excessive prescribing Schedule 6 paragraph 46 Clause 304 Schedule 5 paragraph 44 Practice leaflet Schedule 6 paragraph 76 Clause 438 Schedule 5 paragraph 72 Failure to have an effective system of clinical governance Schedule 6 paragraph 121 Clause 488 Schedule 5 paragraph 112 Inadequate patient records Schedule 6 paragraph 73 Clause 427 Schedule 5 paragraph 70 Failure of the contractor to carry out his obligations under the agreement with reasonable care and skill Schedule 6 paragraph 67 Clause 25 Schedule 5 paragraph 67 Failure by the contractor to adequately check the qualifications and other matters relating to a healthcare professional seeking to perform services under the contract. For example, this includes (but is not limited to):
organisation) for ensuring the quality of the workforce by managing their primary care medical performers list. This covers admission of doctors to the list, removal or contingent removal of doctors from the list, and doctors’ disqualification for inclusion in a list. The NHS CB The NHS CB is the commissioning organisation that commissions primary medical services from general practice that meet the needs of their local populations. Quality and outcomes framework (QOF) The quality and outcomes framework (QOF) is a voluntary annual reward and incentive programme for all GP surgeries in England, detailing practice achievement results. It is not about performance management but resourcing and then rewarding good practice. Remedial notice Where the contractor has breached the contract, other than in certain specified situations and the breach is capable of remedy, the commissioner shall, before taking any action it is otherwise entitled to take under the contract, serve a notice on the contractor requiring it to remedy the breach. Serious untoward incident (SUI) The principle definition is something out of the ordinary or unexpected, with the potential to cause serious harm, and/or likely to attract public and media interest that occurs on NHS premises or in providing an NHS or a commissioned service. SUIs are not exclusively clinical issues. Stakeholders Stakeholders are a person, group, organisation, or system who affects or can be affected by an organisation's actions. The Family Health Services Appeal Unit (FHSAU) The FHSAU is the arm of the NHSLA that is responsible for ensuring a prompt and fair resolution of disputes between primary care practitioners and the NHS CB in cases where the contractor has elected to be considered as an NHS body for the purposes of the contract or has elected to use the NHS procedures, or the board has sought to use those procedures and the contractor has agreed. If the contractor is not an NHS body for the purposes of the contract the matter shall be referred to the civil courts for determination. Termination of contract The commissioner may serve notice on the contractor terminating the contract with effect from such a date as may be specified in that notice. Whistle blowing A whistleblower is a person who raises a concern about wrongdoing occurring in an organisation or body of people.