Legal regulations are expected to confirm shortly that the clinical commissioning group quality premium bonus can be paid to individual GP practices but must “improve services for patients”, HSJ has learned.
HSJ understands details of secondary legislation making provision for the premium have been agreed in recent days, just over three weeks before the new commissioning system will be introduced.
The regulations, made under the Health Act, will allow the NHS Commissioning Board to pay and set rules for the CCG quality bonus scheme, sources said.
They will also pave the way for the board to in the near future announced how much the premium is worth. This is still expected to be £5 per head of each CCG’s population, or about that sum, although it has yet to be confirmed, and is likely to require Treasury approval. The £5 figure would amount to about £250m nationally.
The regulations will permit the commissioning board to withhold all or part of a CCG’s quality premium if it fails to meet requirements on a set of quality indicators; financial requirements; or performance indictors in the NHS constitution, including waiting times.
Those rules accord with guidance published by the NHS Commissioning Board, in anticipation of the regulations, in December.
The regulations will also confirm that – while CCG must show use of their quality premium will “improve services for patients” – CCGs will be allowed to pay it directly to their member practices.
The prospect of CCGs paying funds to member GPs has proved controversial in the past, because of the potential for conflict of interest and personal benefit.
However, the premium has previously been seen as an incentive for GPs to be involved in commissioning and attempt to improve performance for their population.
Many CCGs are believed to be keen for it to be spent on general practice and community services.
It is unclear how use of the funds will be policed. However, it is likely the commissioning board will publish guidance about how the money can be used and require CCGs to publish details of how it has been spent.