Website of the Department of Health

QMAS implementation on course

The new national IT system for measuring and rewarding achievement against national primary care standards is now being rolled out to practices.

The quality management and analysis system (QMAS) will soon provide some 9,000 practices across 303 primary care trusts with evidence and feedback on their quality of patient care.

Under the quality and outcomes framework (QOF), it is essential that the payment rules underpinning the new GMS contract are implemented consistently across all systems and all practices in England, so as to reward primary care contractors fairly and equitably. QMAS - part of the National Programme for IT (NPfIT) - will ensure this.

QMAS accurately calculates from GPs' own clinical information systems their achievements (points), entitlements (pounds), prevalence and list size in relation to an individual practice's delivery against nationally-agreed standards.

It will also provide PCTs and practices with the same data about quality achievement against aspiration, estimated prevalence levels and current payment levels. Practices will only be able to access their own data and PCTs will not be able to access patient level data.

Clinical achievement data will be updated automatically through QMAS each month from practices' GP clinical computer systems. Practices will also be able to send clinical reports on an ad-hoc basis to inform their progress on achievement.

The GP clinical system suppliers have had to pass a stringent NPfIT testing process to gain GMS Certification. Once passed QMAS GMS software is implemented in to practices to enable clinical data to be automatically submitted.

This process is already well underway. Practices are able to manually enter their non-clinical achievement directly into QMAS using specially designed web forms.

The recent QMAS Bulletin for practices provides detailed information on implementing the new system. It was piloted during August and national implementation is now underway.

Only registered users can gain access to QMAS through a unique user ID and password. Practices can authorise staff to either view and update practice information or just view it.

NPfIT GMS project lead Graham King said: 'QMAS supports the underpinning principles of the quality and outcomes framework by bringing achievement in quality of care to the clinician's desktop.'

All practices must ensure their GP clinical system holds their correct six-digit unique national practice ID. Failure to do this means QMAS may not recognise the system and reject the data.

More details about how the system will work, including 'screenshots' of what new users will find, are on the QMAS training website (requires NHSNet connection) at:

• QMAS training (for NHSNet users) (opens new window)

Practices without access to NHSnet can access this information at:

Quality assessments and training ­update

Training for quality and outcomes framework (QOF) assessors stresses the importance of closer working between practices and PCTs. 

The training highlights the need for PCTs to work with their practices before, during and after the QOF assessment to support the development of a successful process.

More than 3,200 people have attended the first part of the QOF assessor training with 371 people also attending the PCT QOF lead sessions. The first phase of the training is now complete, with phase 2 beginning in September.

The National and Primary Care Trust Development Programme (NatPaCT) has also reiterated that PCTs can draw from a range of backgrounds when appointing assessors. A common query is whether PCTs can select practice managers as part of QOF assessor teams. This is possible but, as with all their assessors, they will need to bear in mind any potential conflicts of interest.

The growing number of lay assessors and GPs involved in the training events so far indicates the progress made by PCTs in recruiting assessor teams.

A total of 15 training events are taking place in the second phase of training throughout September, designed to help assessor teams develop skills through case studies using mock interviews, feedback and report writing. One additional event has already been scheduled due to the high level of bookings. 

Trainers will be taking delegates through the skill processes required to underpin the assessment. Assessor teams should attend together to get the most benefit from the day, as individual assessors will find it difficult to participate fully. Where a PCT has more than one team, complete teams may attend different events.

QOF leads should ensure that every participant understands the overall assessment process, has had access to part one training materials and is familiar with assessment guidance and the recent quality management and analysis system (QMAS) bulletins.

Department of Health principal officer for medical care Philip Leech said: 'Each assessment will be unique and the amount of time that assessors need to spend in individual practices will vary, depending on the size of the practice, the number of staff they wish to interview, the agreed scope of the visit and the quality of pre-visit information provided.

 'The annual review visit and the assessors' report is very much one element of the continuing development of GP practices and aims to help GPs and other staff plan improvements in the care that they provide for patients.'

To register for training, or if you wish to discuss how to become an assessor, contact your PCT QOF lead. Leads who haven't yet received booking details for the second phase of events should e-mail:

• natpactevents@dh.gsi.gov.uk (opens new window)

immediately.

Any queries about assessor training should be e-mailed to:

• kay.newton@dh.gsi.gov.uk (opens new window)

NatPaCT provides a range of resources to support the NHS to implement the new primary care medical services contracts, together with other stakeholders.

More information at:

• NatPaCT website (opens new window)

Review templates available

Templates to assist practices and PCTs in planning for the QOF review process are now available to download from the NatPaCT website.

Various examples have been produced by PCTs on how they intend to carry out the reviews. Examples include:

You can access the templates at:

• Quality and outcomes framework (opens new window)

Dedicated support for practice management

A dedicated telephone and e-mail service for practice managers has been developed by the National Association of Primary Care (NAPC).

Practice managers can phone or e-mail for help on all non-clinical management issues. These can include job descriptions and roles and advice on negotiating contracts with primary care trusts.

They are also given access to a network of support practices through which an experienced local practice manager acts as a 'mentor' providing hands-on support.

The NAPC support work is part of a wider Department of Health strategy to support the GMS contract roll-out and is aimed specifically at GP practice management.

The National Primary Care Development Team (NPDT) and NHS Modernisation Agency's clinical governance support team have also designed a primary care management development programme.

It will include a primary care management structure, from PCTs to practices, to support both strategic policy and individual managers' developmental needs.

Initially. it will be aimed at managers who have recently begun a career in a PCT or a practice, or those who have identified areas of personal development.

PCTs and practices will be invited shortly to take part in a pilot of the first phase, focusing on patient access, managing long-term conditions and reducing health inequalities.

For more information about NAPC's support call Maggie Marum on 0207 636 8226 or Sally Kitt on 0207 636 1255.

More information at:

• National Association of Primary Care (opens new window)

or at:

• Primary care contracting (opens new window)

about the NatPaCT toolkit and more support

For more on the NPDT programme contact Caroline Pike on 07970 836958 or e-mail:

• caroline.pike@npdt.nhs.uk (opens new window)

or Lucy Warner on 07795 413715, e-mail:

• lucy.warner@ncgst.nhs.uk (opens new window)

Helping practices deliver improvements

A training initiative has been developed to help GP practice staff apply specific techniques to improve all aspects of their work.

The quality improvement skills for primary care (QuISP) programme has been jointly developed by the National Primary Care Development Team (NPDT) and the Royal College of GPs.

QuISP enables practices to make sustainable changes by applying improvement skills to any clinical or organisational challenge, ranging from chronic disease management to analysing practice data.

After an initial successful pilot phase, QuISP is being rolled out nationally through the 11 local NPDT centres. The skills gained will also support teams in the achievement of the quality and outcomes framework (QOF).

QuISP has been designed to support team building and the application of quality improvement skills focused on specific practice priorities. Tools and techniques include analysing information, process mapping and psychology of change.

Practices choose their own priorities to work on based on QOF and so identify their own improvement measures which will be reported on a regular basis throughout the programme. Practices then choose their own team to participate on the programme, with two to four people attending the workshops.

Changes being introduced as a result include:

QulSP clinical lead and GP affiliate to the NPDT Dr John Bibby said: 'The prospect of practice teams developing quality improvement skills whilst tackling an issue of importance to their practice is really exciting.

The expected improvement both in the nGMS quality outcomes framework and more widely in primary care will be of direct benefit to patients and primary care teams.'

Feedback has been positive for training programmes already launched in the north, east midlands and south east. Northern practices said they appreciated having the time to discuss work away from the surgery, while those in the east midlands described the training as 'very useful'.

North Bradford, west midlands and southern centre programmes launched in July and programmes for the eastern, peninsula and west country programmes start in September.

Each programme runs as a series of three, one-day workshops over a two to three-month period, for six to 10 practice teams.

For details of how to participate call Jacquie White on 0161 236 1566 or visit:

• Quality Improvement Skills for Primary Care (QuISP) (opens new window)

Round-up Learning exchange events

PCTs are invited to submit posters on work they have done towards maximising the benefits of new primary care contracts.

They are also being asked to put forward speakers for the following series of learning exchange events:

• NatPaCT (opens new window)

Anyone interested in contributing posters or being a speaker should e-mail:

• helen.northall@dh.gsi.gov.uk (opens new window)

or:

Working in Partnership programme

The Working in Partnership programme is addressing key elements of demand management in general practice.

As outlined within the new GMS contract, it is designed to help develop schemes to maximise health services and provide evidence-based alternatives to general practice.

Programme manager Clayre La Trobe has been appointed for two years to support an advisory group in scoping, evaluating and encouraging the spread of existing good practice and projects.

For more information e-mail:

or 07795 642298 or visit:

• Primary care workload management (opens new window)

PMS guidance: out-of-hours opt out price for PMS

Guidance replacing paragraph 6.13 of Sustaining Innovation through New PMS Arrangements has been published. It provides notification of the finalised opt out price for PMS.

More information at: