Primary care service frameworks
About the primary care service frameworks
Background information for commissioners and providers.
Published November 2009
PCSF for personalised care planning
A new outline specification for personalised care planning is now available. It differs from the other primary care service frameworks published by NHS PCC because personalised care planning is more about an approach to service delivery than the services themselves. The outline specification aims to help PCTs to develop their local thinking and approach, and work with providers to change existing ways of working, rather than commission additional services.
Published June 2009
Primary care service framework: Accessible and Responsive General Practice
A new primary care service framework to support improvements in the accessiblility and responsiveness of GP services has been developed. This forms part of a suite of documents to support PCTs and practices that will be published over the coming months to support improvements in access and responsiveness.
Published May 2009
Primary care service framework: Alcohol
The Primary Care Service Framework is for adult patients who are drinking to hazardous and harmful or dependent levels. This document has been updated to include recent policy changes and is supported by a range of enhanced tools to support implementation. A complementary suite of resources and supportive notes is also available.
This document provides examples of good practice around alcohol services in primary care and can be adapted and used as a basis for an enhanced service via a schedule within a local primary care contract or service level agreement.
In addition, the updated document supports the introduction of the new clinical directed enhanced service (DES) for alcohol, which started from April 2008 and will run for two years:
http://www.nhsemployers.org/SiteCollectionDocuments/Clinical_DES_Guidance_mh23032009.pdf
Alcohol care pathway - primary care and Read Codes DES
Alcohol care pathway - primary care
Alcohol use disorder identification test
Alcohol use disorder identification test - consumption
Alcohol use disorder identification test - primary care
Single alcohol screening questionnaire
Leaflet to support the delivery of Brief Advice Identification and Brief Advice Tool
Primary care computer system templates EMIS systems
The following information is for clinical EMIS system users only (to be opened via the EMIS system)
Published May 2009
Primary care service framework: Gypsies and Travellers
This PCSF has been developed to assist commissioners in ensuring that Gypsy and Traveller communities are able to access mainstream primary care. It may be used to assist PCTs to design new services or to adapt or front-end existing ones to make them accessible.
Published February 2009
Primary care service framework: vascular checks
Primary care service framework: adolescent health
Primary care service framework: obesity
Primary care service framework: long-term conditions
Primary care service framework: support for self care
Primary care service framework: sexual health
Primary care service framework: Peripheral Arterial Disease
Blank service framework for local adaptation
Download the feedback questionnaire
What are these frameworks?
Each primary care service framework is a generic, comprehensive and enhanced service specification for PCT commissioners and practice-based commissioners for 2007/08. These frameworks:
- Help commissioners and providers consider, as a starting point, an integrated approach to enhanced service provision in primary care.
- Describe the key requirements for a holistic, enhanced service – eg. appropriate processes, improvements in health outcomes, service inputs and outputs, staffing competencies, integrated governance, information etc.
- Give an opportunity to consider which level of this enhanced service provision and contractual route(s) would be most appropriate to adopt locally, such as GMS, PMS, APMS or PCTMS , with the most appropriate providers available.
What is their context?
Each primary care service framework has been developed in the context of the commissioning framework, White Paper implementation, key national priorities and targets, and delivery mechanisms of practice-based commissioning. They:
- Reflect the key considerations for practice-based commissioners in developing local service business plans.
- Are flexible enough to sit alongside/complement current core and extended primary care provision as necessary.
- Are applicable across the expanding primary care network of providers and within different local circumstances.
How should they be applied in practice?
Each primary care service framework should be:
- Localised – Local needs assessments and delivery plan priorities should determine the selection of objectives from those available in Section 7 as well as the choice and integration of potential local providers. It may be necessary to tailor the specification, targeting particular populations or clinical groups, making the specification more sensitive and manageable.
- Demonstrable – The selection of objectives will determine the number and type of local, simple outcome-based measures in order to assess impact (eg. quality of service, performance against national/local priorities, health improvement) taking into account where and how data will be collected and analysed (eg practice registers or hospital episode statistics) and where new data may need to be generated.
- Appropriate – Will be necessary to consider the most appropriate provider(s) and how they cooperate within the primary care network to achieve planned outcomes. The most appropriate contracting route (eg enhanced service, APMS, etc) will need to be selected. It may be appropriate to nominate a lead provider.
- Value added – There is no nationally fixed price for the frameworks. Each assumes a level over and above core or additional services in primary care. The whole/part of the service delivered by each provider (in the network of provision) will need to be affordable, add value and not duplicate current core services delivered (by them or others) to avoid paying twice for the same service. Incentives for achieving specific outcomes which are over and above core funding or PBC budgets may be appropriate.
- Patient-centred – The tailored specification must have specific patient and/or community involvement in deciding the most appropriate elements of the service to be included, how they are best delivered, and how patient experiences will be measured.
- Equitable – Connections between commissioning activity and equality and human rights is implicit, as properly designed and executed commissioning both reduces health inequalities and can act to promote equality of access and health outcomes. Legal obligations now involve systematically identifying and then eliminating any discriminatory practice (be that in employment or service provision), and positively promoting equality of opportunity. This is also applicable to the independent contractor community as well as to all of the services that the PCT commissions from other providers – whether these are NHS, third sector or private sector organisations.
How have they been developed?
Each primary care service framework is underpinned by the current evidence base and Choosing Health priorities. They have been developed:
- With expert professional and managerial input from the field together with practical considerations collated from a variety of stakeholders.
- Through a multi-agency steering group and been tested in draft with leading primary care commissioners, providers, clinicians and other healthcare professionals.
- As ‘works in progress’ which can be continually developed and improved.
Feedback
NHS Primary Care Commissioning would like your feedback on these frameworks to assist in their on-going development and sharing of good practice across primary care. Please complete the brief feedback questionnaire and return it to rebecca.thornley@pcc.nhs.uk
Acknowledgements
The Department of Health and NHS Primary Care Commissioning would like to thank all those individuals, departments and organisations who have contributed to the development of this primary care service framework.
Click here to download the supporting statements
Primary care commissioners and providers should read the supporting statements before using all or parts of these framework documents in any planning, commissioning or implementation process.
Suite of resources to complement the alcohol primary care service framework
- Blackpool PCT Acorn Awards 2007 - Service Redesign (pdf)
- Camden PCT Alcohol Strategy 2009 (pdf)
- Devon and Torbay Drug and Alcohol Services - Comprehensive Risk Assessment (pdf)
- Newcastle PCT - Models of Care for Alcohol Misusers (pdf)
- Salford PCT Fast Alcohol Screening Test (FAST) (pdf)
- Severity of Alcohol Dependancy Questionnaire (pdf)
Primary care service framework: management of health for people with learning disabilities
Suite of practical resources for learning disabilities health checks
The following suite of practical resources will help GP practices deliver health checks for people with learning disabilities with support from community learning disability teams. They offer direction and practical assistance to carry out and support annual health checks.
These resources have been developed to complement the primary care service framework: Management of Health for People with Learning Disabilities in Primary Care (July 2007). These practical tools, put together jointly by Primary Care Unlimited, the Valuing People Support Team and the Foundation for People with Learning Disabilities, focus on the delivery of annual health checks for people with learning disabilities by GP practices.
Annual health checks
- Health Checks - Summary of Steps and Support (pdf)
- GP Practice Step by Step Guide - at a glance (pdf)
- GP Practice Step by Step Guide supporting information (pdf)
- Health Checks - Role of the Community Learning Disability Team (pdf )
- Health Checks - Role of the PCT (pdf)
GP Information Systems e-templates and loading instructions
Following feedback, these templates have been re-ordered and there are now new loading instructions. Click on the links to access loading instructions for the following templates.
Template for iSOFT Premiere systems
Template for iSOFT Synergy
- Enhanced_Service_Learning_Disabilities.tex
- ES Learning Disabilities.gdl
- ES Learning Disabilities.wse
- (Practices should contact iSOFT helpdesk for assistance as loading instructions were not available)
Template for Vision Systems
Template for EMIS LV systems
- Loading LD Template (Word)
- LEARNING (DAT)
- Downloading from email to floppy learning disabilities template (Word)
Strategic health facilitator for learning disabilities
- Clinical Lead H Grade job description
- Clinical Lead H Grade person spec
- Clinical Lead Health Facilitator full KSF
Thanks to Susan Brady, strategic health facilitator at South Birmingham PCT, for supplying a number of practical resources which are already well used in GP practices and details of the clinical lead job description for the strategic health facilitator role.
Supporting people with dysphagia
The NPSA has issued a resource pack for health professionals, service users and carers for assessing and supporting people with dysphagia. The toolkit is available on the NPSA website (www.npsa.nhs.uk/web/sitemap) under resources with a section for GPs, which has been accredited by the RSGP.