Chapter 6 – Improving access in England
6.1 From April 2006, a new Access Directed Enhanced Services (DES) will replace the current 2005/06 Access DES and the 50 Quality and Outcomes Framework (QOF) Access points. Local payments to practices in respect of these two existing schemes should cease following payments for the 2005/06 financial year. The specification for the new Access DES can be found at Annex 4 .
6.2 The potential or actual cost of the new DES locally may not equal the same value that PCTs in England have historically paid through the QOF Access points and the existing Access DES for 2005/06. Any resultant variation will need to be managed on an individual Primary Care Trust (PCT) basis. PCTs should note that the full financial envelope for component two will be payable only if all practices achieve the highest thresholds in each of the four dimensions set out in component two of the DES.
6.3 The first component of the new DES will be payable to practices who commit to participate in the monthly Primary Care Access Survey and work towards delivery of each element of component two.
6.4 Practices which provide the required commitment through a written practice plan agreed with the PCT should be paid the equivalent of 69p per registered patient (as measured by the Exeter system on 1 April 2006). The practice plan should describe the action they will be taking to deliver improvements to the areas which are rewarded under component two.
6.5 Following confirmation by the PCT that the practice is eligible for component one, payment must be made as soon as possible. Where a practice subsequently fails to achieve the lower threshold levels for the first three elements of component 2, or does not take part in the monthly PCT survey (PCAS), the associated aspiration payment will become repayable by the practice.
6.6 Reward for the second component of the new DES will be payable on the outcome of the new patient experience survey and will be calculated according to how a practice scores in each of the four access dimensions, as outlined in the specification. Payments to practices for 2006/07 will be based on the practice list size as at 1 January 2007 and will be made by PCTs as soon as responses to the survey have been returned and validated.
6.7 The new survey is expected to be in place during quarter four of 2006/07. Collecting, processing and analysing the individual returns will take time so PCTs (and practices) should plan on the basis that payments for component two may be made in the first quarter of the following financial year (ie from April 2007).
6.8 There is further information about the patient experience survey in Chapter 8 .