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    DES - Minor Surgery 2009-10 Contract Mechanism and Specification

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    IndiIndhysa
    This document outlines the specifications for a Directed Enhanced Service (DES) contract for minor surgery procedures performed by general practitioners in primary care settings from 2009-2010. It describes the scope of minor surgical procedures covered, eligibility requirements for practices and clinicians, facility and equipment standards, and the payment mechanism. Practices will be paid set fees for different procedure types and have the opportunity to reconcile payments based on their actual activity levels from the previous three years.

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    DES - Minor Surgery 2009-10 Contract Mechanism and Specification

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    IndiIndhysa
    23 views3 pages
    This document outlines the specifications for a Directed Enhanced Service (DES) contract for minor surgery procedures performed by general practitioners in primary care settings from 2009-2010. It describes the scope of minor surgical procedures covered, eligibility requirements for practices and clinicians, facility and equipment standards, and the payment mechanism. Practices will be paid set fees for different procedure types and have the opportunity to reconcile payments based on their actual activity levels from the previous three years.

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    This document outlines the specifications for a Directed Enhanced Service (DES) contract for minor surgery procedures performed by general practitioners in primary care settings from 2009-2010. It describes the scope of minor surgical procedures covered, eligibility requirements for practices and clinicians, facility and equipment standards, and the payment mechanism. Practices will be paid set fees for different procedure types and have the opportunity to reconcile payments based on their actual activity levels from the previous three years.

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    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    23 views3 pages

    DES - Minor Surgery 2009-10 Contract Mechanism and Specification

    Uploaded by

    IndiIndhysa
    This document outlines the specifications for a Directed Enhanced Service (DES) contract for minor surgery procedures performed by general practitioners in primary care settings from 2009-2010. It describes the scope of minor surgical procedures covered, eligibility requirements for practices and clinicians, facility and equipment standards, and the payment mechanism. Practices will be paid set fees for different procedure types and have the opportunity to reconcile payments based on their actual activity levels from the previous three years.

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    © All Rights Reserved
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    Contract Specification DES: Minor Surgery (GG&C) 2009-10 31 03 2009 DES - Minor Surgery 2009-10 Contract Mechanism and

    d Specification
    Introduction 1! "#ere i$ e%i&ence fro' (it#in t#e )* an& a+roa& t#at 'inor $urgica, proce&ure$ carrie& out +y genera, practitioner$ in genera, practice pre'i$e$ #a%e #ig# ,e%e,$ of patient $ati$faction an& are #ig#,y co$t-effecti%e! -1. 2. 3/ Since 1 0pri, 1990 genera, practitioner$ on 1ea,t# 0ut#ority 'inor $urgery ,i$t$ (an& t#eir e2ui%a,ent$) #a%e +een a+,e to recei%e pay'ent for un&erta3ing a range -1/ of 'inor $urgery proce&ure$ on t#eir patient$! 2! "#ere #a$ +een a #uge %ariation in t#e range of proce&ure$ un&erta3en at practice ,e%e,! Many practice$ #a%e pro%i&e& cryot#erapy. curettage an& cauteri$ation on,y (#i,$t $ti,, referring ot#er 'inor $urgery into t#e $econ&ary $ector! "#i$ Directe& En#ance& Ser%ice $c#e'e. (#ic# 'u$t +e co''i$$ione& +y e%ery 4C5. $ee3$ to en$ure t#at t#ere i$ t#e opportunity to pro%i&e t#e 'a6i'u' range of 'inor $urgery in t#e pri'ary care $ector! Scope of service to be provided 3! Cryot#erapy. curettage an& cauteri$ation (i,, continue to +e pro%i&e& +y genera, practitioner$ a$ an a&&itiona, $er%ice an& practice$ (i$#ing to opt out of pro%i&ing t#e$e treat'ent$ (i,, +e o+,ige& to app,y to &o $o in t#e pre$cri+e& 'anner! 4roce&ure$ in t#e categorie$ +e,o( an& ot#er proce&ure$. (#ic# t#e practice i$ &ee'e& co'petent to carry out. (i,, +e co%ere& +y a Directe& En#ance& Ser%ice (DES)! "#e$e proce&ure$ #a%e +een c,a$$ifie& into t#e fo,,o(ing t#ree grouping$ for pay'ent: - in7ection$ ('u$c,e$. ten&on$. 7oint$. %arico$e %ein$ an& pi,e$) - in%a$i%e proce&ure$. inc,u&ing inci$ion$ an& e6ci$ion$ E igibi ity to provide the service 8! 0 practice 'ay +e accepte& for t#e pro%i$ion of t#i$ DES if it #a$ a partner. e'p,oyee or $u+contractor. (#o #a$ t#e nece$$ary $3i,,$ an& e6perience to carry out t#e contracte& proce&ure$ in ,ine (it# t#e princip,e$ of t#e generic G4(S9 gui&ance or t#e $pecific e6a'p,e$ a$ t#ey are &e%e,ope&! C,inician$ ta3ing part in 'inor $urgery $#ou,& +e co'petent in re$u$citation an&. a$ for ot#er area$ of c,inica, practice. #a%e a re$pon$i+i,ity for en$uring t#at t#eir $3i,,$ are regu,ar,y up&ate&! Doctor$ carrying out 'inor $urgery $#ou,& &e'on$trate a continuing $u$taine& ,e%e, of acti%ity. con&uct regu,ar au&it$. +e apprai$e& on (#at t#ey &o an& ta3e part in nece$$ary $upporti%e e&ucationa, acti%itie$! :! ;#ere a 4C5 +e,ie%e$ a &octor carrying out 'inor $urgery i$ not co'p,ying (it# t#e ter'$ of t#e contract it $#ou,& in%o3e a re'e&ia, notice accor&ing to t#e proce&ure ,ai& out in <egu,ation! "#ere i$ con$i&era+,e gui&ance -8/ a%ai,a+,e on tec#ni2ue$ an& faci,itie$ for con&ucting 'inor $urgery in genera, practice! i) Sati$factory faci,itie$ 4C5$ $#ou,& +e $ati$fie& t#at practice$ carrying out 'inor $urgery #a%e $uc# faci,itie$ a$ are nece$$ary to ena+,e t#e' proper,y to pro%i&e 'inor $urgery $er%ice$! 0&e2uate an& appropriate e2uip'ent $#ou,& +e a%ai,a+,e for t#e &octor to un&erta3e t#e proce&ure$ c#o$en. an& $#ou,& a,$o inc,u&e appropriate e2uip'ent for re$u$citation! =ationa, gui&ance on pre'i$e$ $tan&ar&$ #a$ +een i$$ue&! -8/! ii) =ur$ing $upport <egi$tere& nur$e$ can pro%i&e care an& $upport to patient$ un&ergoing 'inor $urgery! =ur$e$ a$$i$ting in 'inor $urgery proce&ure$ $#ou,& +e appropriate,y traine& an& co'petent. ta3ing into con$i&eration t#eir profe$$iona, accounta+i,ity an& t#e )nite& *ing&o' Centra, Counci, ()*CC) gui&e,ine$ on t#e $cope of profe$$iona, practice! iii) Steri,i$ation an& infection contro, 0,t#oug# genera, practitioner 'inor $urgery #a$ a ,o(

    Contract Specification DES: Minor Surgery (GG&C) 2009-10 31 03 2009


    inci&ence of co'p,ication$. it i$ i'portant t#at practice$ pro%i&ing 'inor $urgery operate to t#e #ig#e$t po$$i+,e $tan&ar&$! 4ractice$ $#ou,& ta3e a&%antage of any of t#e fo,,o(ing arrange'ent$: 1! $teri,e pac3$ fro' t#e ,oca, CSSD 2! &i$po$a+,e $teri,e in$tru'ent$ 3! 0ppro%e& $teri,i$ation proce&ure$ t#at co'p,y (it# nationa, gui&e,ine$! Genera, practitioner$ are re$pon$i+,e for t#e effecti%e operation an& 'aintenance of $teri,i$ing e2uip'ent in t#eir practice$! 4ractice$ 'u$t #a%e infection contro, po,icie$ t#at are co'p,iant (it# nationa, gui&e,ine$ inc,u&ing inter a,ia t#e #an&,ing of u$e& in$tru'ent$. e6ci$e& $peci'en$ an& t#e &i$po$a, of c,inica, (a$te! i%) Con$ent 9n eac# ca$e t#e patient $#ou,& +e fu,,y infor'e& of t#e treat'ent option$ an& t#e treat'ent propo$e&! "#e patient $#ou,& gi%e (ritten con$ent for t#e proce&ure to +e carrie& out an& t#e co'p,ete& =1S con$ent for' $#ou,& +e fi,e& in t#e patient>$ ,ife,ong 'e&ica, recor&! %) 4at#o,ogy 0,, ti$$ue re'o%e& +y 'inor $urgery $#ou,& +e $ent routine,y for #i$to,ogica, e6a'ination un,e$$ t#ere are e6ceptiona, or accepta+,e rea$on$ for not &oing $o! %i) 0u&it ?u,, recor&$ of a,, proce&ure$ $#ou,& +e 'aintaine& in $uc# a (ay t#at aggregate& &ata an& &etai,$ of in&i%i&ua, patient$ are rea&i,y acce$$i+,e! 4ractice$ $#ou,& regu,ar,y au&it an& peer-re%ie( 'inor $urgery (or3! 4o$$i+,e topic$ for au&it inc,u&e: c,inica, outco'e$. rate$ of infection an& une6pecte& or inco'p,ete e6ci$ion of +a$a, ce,, tu'our$ or pig'ente& ,e$ion$ (#ic# fo,,o(ing #i$to,ogica, e6a'ination are foun& to +e 'a,ignant! !enchmar" pricing @! "reat'ent$ un&er t#i$ DES (i,, +e price& &epen&ing on co'p,e6ity of proce&ure. in%o,%e'ent of ot#er $taff an& u$e of $pecia,i$e& e2uip'ent! 9n 2009-10 pay'ent for an in7ection (i,, +e A82!@2 an& for cutting $urgery (inci$ion$ & e6ci$ion$) t#e fee (i,, +e AB:!28! <eference$ 1! Co(y 0. DraEier F. ?a,, M. "#o'a$ *F. ;i,,ia'$ D"! Gua,ity of 'inor $urgery +y genera, practitioner$ in 1990 an& 1991!Driti$# Fourna, of Genera, 4ractice 199:: 88H 3@8-3@: 2! "arraga CopeE 4F. Marin =ieto E. Garcia 5,'o D. Ce,a&a <o&rigueE 0. So,era 0,+ero F! -Econo'ic i'pact of t#e intro&uction of a 'inor $urgery progra' in pri'ary care/! -Spani$#/ 0tencion 4ri'aria 2001H2I(:):33:-B! 3! CopeE Santiago 0. Cara 4enaran&a <. &e Migue, Go'eE 0. 4ereE CopeE 4. <i+e$ MartineE E! -Minor $urgery in pri'ary care: con$u'er $ati$faction/! -Spani$#/ 0tencion 4ri'aria 2000H2@(2):91-:!! 8! Depart'ent of 1ea,t#! 1ea,t# +ui,&ing note 8@: Genera, 'e&ica, practice pre'i$e$! Con&on: Depart'ent of 1ea,t#! Depart'ent of 1ea,t#! Dui,&ing note 22: 0cci&ent an& e'ergency &epart'ent$! Con&on: Depart'ent of 1ea,t#!

    Contract Specification DES: Minor Surgery (GG&C) 2009-10 31 03 2009


    #$S %%&C Service Mechanism "#i$ DES i$ $p,it into 2 $ection$. in7ection$ an& inci$ion$ e6ci$ion$! 4ractice$ are to +e a,,o(e& to opt in to one or +ot# $ection$! "#e pay'ent 'ec#ani$' acro$$ =1S Greater G,a$go( & C,y&e for 2009-10 (i,, fo,,o( t#e 'ec#ani$' carrie& out in 200B-09! "#i$ 'ec#ani$' a,,ocate& t#e tota, +u&get a%ai,a+,e for t#i$ DES acro$$ t#e 4ractice$. +a$e& on t#eir #i$torica, acti%ity an& pay'ent$! So'e 4ractice$ carrie& out 'ore (or3 t#an t#eir +u&get a,,ocation cou,& $upport an& ot#er$ carrie& out ,e$$! "#e +u&get not $pent +y t#i$ ,atter group (a$ &i$tri+ute& on an e2uita+,e +a$i$ (after year en&) to t#o$e 4ractice$ (#o$e c,ai'$ e6cee&e& t#eir $#are of t#e tota, +u&get! 0ctua, 4ractice acti%ity i$ 3no(n for eac# 4ractice for t#e year$ 2008-0: to 200@-0I (3 year$)! "#i$ acti%ity #a$ +een a%erage& for eac# 4ractice an& (a$ t#e proce&ure co$t$ are 3no(n) a $pen& figure appen&e&. if t#e 200@-0I (a$ #ig#er. t#en t#i$ (a$ u$e& in p,ace of t#e a%erage figure! "#u$ an in&icati%e +u&get (a$ a%ai,a+,e for eac# 4ractice for 200B-09! "#i$ 4ractice figure (a$ pai& in t(e,ft#$ (a$ a +,oc3 contract $u') to eac# 4ractice! 4ractice$ (ere t#en to $u+'it t#eir actua, acti%ity figure$ to t#e GMS Contract tea' at year en&! ;#ere acti%ity (a$ ,o(er t#an t#at a,rea&y pai& for t#roug# t#e D,oc3 Contract pay'ent$. a c,a( +ac3 (a$ 'a&e! ;#ere actua, acti%ity (a$ #ig#er t#an t#at pai& for t#roug# t#e D,oc3 Contract pay'ent$. a furt#er pay'ent (a$ 'a&e. +eing an e2uita+,e $#are of t#e fun&$ re,ea$e& t#roug# t#e c,a( +ac3$ fro' ot#er 4ractice$! "#i$ reconci,iation proce$$. +a$e& on t#e pre%iou$ 3no(n acti%ity for 2008-0: to 200@-0I. (i,, a,$o +e i'p,e'ente& for 2009-10. (it# t#e year en& reconci,iation ta3ing p,ace in 0pri, 2010! "#e +u&get a,,ocate& to C,y&e 4ractice$ (i,, +e 3ept $eparate fro' t#at a,,ocate& to G,a$go( 4ractice$. (it# no cro$$-$u+$i&i$ation in 2009-10! Eac# practice i$ re$pon$i+,e for en$uring t#at t#e c,inician carrying out 'inor $urgery i$ carrying out enoug# proce&ure$ to 'aintain t#eir e6perti$e! C,inician$ (i,, on,y +e a+,e to carry out 'inor $urgery un&er t#i$ DES if t#ey (ere regi$tere& on t#e current 'inor $urgery ,i$t. or in future ((#en t#e 'inor $urgery ,i$t no ,onger e6i$t$) #a& &e'on$trate& to GG=1SD t#at t#ey #a& ac#ie%e& t#e $tan&ar& re2uire& current,y to +e regi$tere& on t#e ,i$t (G4(S9)! Decontamination of 'eusab e Devices 4ractice$ (i$#ing to pro%i&e t#i$ DES $#ou,& note t#e current gui&ance concerning t#e &econta'ination of reu$a+,e &e%ice$ an& 'u$t co'p,y (it# t#i$! GG=1SD i$ a(are of t(o co'panie$ (#ic# can $upp,y $ing,e in$tru'ent$: D! Draun Me&ica, Ct& "EC (0118) 22: 9000 <o+in$on Care Ct& "EC 01909 I3:000 4ractice$ 'ay (i$# to contact t#e$e co'panie$ an& e%a,uate t#eir pro&uct$ for $uita+i,ity!

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