Dudley Strategy for Tackling Health Inequalities 2010-15

8. DELIVERING THE SERVICES THAT WILL MAKE A DIFFERENCE8.1 PRIMARY CARE1. BackgroundThis chapter should be read in conjunction with the Reaching Excellence – APrimary Care Strategy for Dudley 2009- 2014 (NHS Dudley and Dudley MBC,2009) which highlights a number of key actions to target services to reducehealth inequalities. The needs assessment undertaken to underpin the strategyraised a number of concerns including- Too much variation in GP practice performance- Variable standards of practice management- The need to scale-up prevention and health promotion- Managing long term conditions- Access to Primary Care2. Proposed Actions To Address Health Inequalities In Primary Care2.1. Too much variation in GP practice performanceThe PCT is currently reviewing its performance management arrangements for allGP, dental, opticians and pharmacy contractors. Scorecards are being developed forall contractor services to enable both poor and excellent performance to be identified.This approach also enables contractors to benchmark their own performance at botha local and national level.Where examples of good practice are identified these will be shared and whereunderperformance is an issue support programmes will be established.To support the process of identifying poor performance and dealing with itappropriately the current policy for dealing with performer list issues is beingreviewed and will be adapted to include contract management issues so that there isa dispute policy with a transparent and open process to be followed when areas ofconcern are identified.In some instances, the consequences may mean re-commissioning an entirepractice. Opportunities to provide a re-commissioned service will be subject to thePCT‟s procurement policies and will therefore be open to all potential providers.This approach is being adopted for all contractors but is more developed for GPpractices as a consequence of reviewing Personal Medical Services Contracts (PMS)this year. Traditionally PMS practices have enjoyed a higher level of funding andtherefore the review aims to achieve value for money. We have agreed a key set ofperformance indicators that have been categorised into silver, gold and platinumstandards. Over the coming months negotiations will take place with individualpractices around achieving at least silver standards and an agreed level of gold andplatinum over the next 3 years depending on the level of funding that is beingreceived. The outcome of this piece of work will be that all practices will be achieving178