Agenda Item No: 6.5 REPORT TO: Primary Care Committee MEETING DATE: 15 February 2016 REPORT TITLE: edec Submissions SUMMARY OF REPORT: REPORT RECOMMENDATIONS: FINANCIAL IMPLICATIONS: REPORT CATEGORY: AUTHOR: PRESENTED BY: The electronic practice self-declaration (edec) is an annual mandatory data collection. A number of questions relate to contract requirements and CQC registration requirements. The Committee are requested to consider the options outlined in the paper for issuing of remedial notices. None Tick Formally Receipt Action the recommendations outlined in the report. Debate the content of the report Receive the report for information NHS England Report supported & approved by your Senior Lead NHS England Y OTHER COMMITTEES/ GROUPS CONSULTED: EQUALITY ANALYSIS (EA) : Senior Management Team Executive Management Team Has an EA been completed in respect of this report? Assume this will form part of due diligence. N RISKS: Have any risks been identified / assessed? N State Reference No. if currently on the Risk Register. CONFLICT OF INTEREST: Is there a conflict of interest associated with this report? Y PUBLIC ENGAGEMENT: Has there been any public engagement associated with N this report? PRIVACY STATUS OF THE REPORT: Can the document be shared? N Which Strategic Objective does the report relate to Tick 1 Commission the right services for patients to be seen at the right time, in the right place, by the right professional. 2 Optimise appropriate use of resources and remove inefficiencies. 3 Improve access, quality and choice of service provision within Primary Care 4 Work with colleagues from Secondary Care and Local Authorities to develop seamless care pathways 1
Agenda Item No: 6.5 NHS EL CCG Primary Care Committee 15 Februry 2016 edec submissions 1.0 Background 1.1. The annual electronic practice self-declaration (edec) was first introduced to practices in April 2013 and has replaced the variable arrangements (such as the submission of annual reports) which existed between former Primary Care Trusts and providers of Primary Medical Services. The edec is an annual mandatory data collection. There have been two previous collections 2013/14 and 2014/15. 1.2. Information collected in the edec is covered in 8 categories, these include: 1. Practice Details, 2. Practice Staff, 3. Practice Premises and equipment, 4. Practice services, 5. Information about the practice and its procedures, 6. Governance, 7. Compliance with CQC. 8 GP I.T. 1.3. A number of the questions asked in this declaration relate to the Care Quality Commission s (CQC) registration requirements. To meet the CQC registration requirements, all services regulated by CQC must comply with the law, but in particular, they must comply with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) (as amended). 1.4. The Primary Care Webtool has been developed by NHS England for use by its regional and area teams, clinical commissioning groups and general practices. It mobilises a suite of comparative data and information to support assurance and quality improvement in general practice. 1.5. Collection of the electronic declaration (edec) was via a portal on the Primary Care Webtool which was open from 4 November 2015 to 16 December 2015. 1.6. Responses to the questions were pre-populated with the responses provided to the same questions from the previous year. Practices were required to check the responses were still accurate and to respond to new questions, making a declaration at the end. 1.7. The declaration in its entirety is not published in the public domain. 2
1.8. In 2015/16 in Lancashire 223 of 225 practices submitted before the deadline. Practices were reminded of the deadline by email and telephone. 1.9. There is one practice in East Lancashire which did not submit before the deadline. 1.10. Analysis of the 2014/15 edec was shared with CCGs by NHS England prior to the opening of the portal for 2015/16. The analysis showed where practices provided negative responses to questions using a scoring system to indicate level of risk. 2.0 Policies/Regulations 2.1. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3) (as amended) 2.2. GMS paragraph 115 of Schedule 6 of the National Health Service (General Medical Services Contracts) Regulations 2004 and clauses 566 to 573 of the contract 2.3. Clause 439 of the GMS/PMS contract requires the contractor to at the request of the Board, produce to the Board or a person authorised in writing by the Board, or allow it, or any person authorised by it, to access, on request- 439.1 Any information which is reasonably required by the Board for the purposes of or in connection with the agreement; and 439.2 Any other information which is reasonably required in connection with the Board s functions 2.4. GMS paragraph 125 of Schedule 6 of the National Health Service (General Medical Services Contracts) Regulations 2004 and clause 499 of the contract Clause 499: The Contractor shall comply with all relevant legislation and have regard to all relevant guidance issued by the Board or the Secretary of State or Local Authorities in respect of the exercise of their functions under the 2006 Act 2.5. The main policy and regulatory framework to be referenced in relation to any contractual action which needs to be considered is Chapter 7 (Contract Breaches and Termination) of Policy Book for Primary Medical Services (NHS England January 2016) 2.6. Where the commissioner considers a breach has occurred there are a number of options on how to proceed. Take no action; Agree an action with the contractor; Issue a remedial notice; Issue a breach notice; Apply a contract sanction; or Terminate the contract 3
2.7. Where a breach (GMS/ PMS) is capable of remedy then a remedial notice must be issued by the commissioner before the commissioner takes any other action such as termination. 3.0 Previous edeclaration Submissions 3.1. In previous years remedial notices were issued to practices which failed to submit before the deadline. 3.2. Analysis of the 2014/15 return made available to NHS England highlighted where practices declare negative responses to questions relating to contract requirements and CQC registration requirements. 3.3. The scoring system provided a total declaration score based on a matrix, which considers the relative risk of the question and the response. There were 13 questions weighted 'LOW', 15 weighted 'MEDIUM' and 28 weighted 'HIGH'. 3.4. Following the 2015/16 collection the downloaded data was shared on a CCG by CCG basis to enable comparison to the responses from the previous year. 4.0 Current Situation 4.1. Collection of the electronic declaration (edec) was via a portal on the Primary Care Webtool which was open from 4 November 2015 to 16 December 2015. 4.2. Responses to the questions were pre-populated with the responses provided to the same questions from the previous year. Practices were required to check the responses were still accurate and to respond to new questions, making a declaration at the end. 4.3. In 2015 in Lancashire 223 of 225 practices submitted before the deadline. Practices were reminded of the deadline by email and telephone. 4.4. The declaration in its entirety is not published in the public domain. 4.5. It is proposed that practices are approached in the first instance to provide evidence and assurance that all contractual and CQC registration requirements are being met where negative responses have been declared. 4.6. Where satisfactory assurances with respect to contract and CQC registration requirements are not gained, it is proposed that remedial notices are issued regarding these responses. 5.0 Other Stakeholder Consultation 5.1. None required. 4
6.0 Summary 6.1. Practices are required to submit an annual electronic declaration (edec). The declaration provides assurance that they are meeting contractual and CQC requirements. 6.2. Where responses do not provide this assurance, it is proposed that practices are approached to provide evidence that they are meeting contractual and CQC requirements 6.3. Where this cannot be evidenced it is proposed that remedial notices are issued. 7.0. Recommendations 7.1. The CCG is asked to consider in line with its delegated responsibility for approving the issue of remedial notices to practices: whether it feels it is appropriate to issue remedial notices to those practices o who have failed to submit before the deadline o who have declared negative responses to questions relating to contract requirements and CQC registration requirements Options are: 1. Approve the issue of contract remedial notices by NHS England 2. Not approve the issue of contract remedial notices. JACKIE FORSHAW Head of Primary Care NHS ENGLAND 5