ࡱ> BD?@A @ gbjbj ؝؝] fffffff4^@^@^@h@A|CdvFLFFFG#K /L2444444$WR"XfWQGGWQWQXffFFmYYYWQfFfF2YWQ2YYRtffzFC Fz^@mT<y|D0yˇUˇ<zffffzˇfzLLMY)N|NLLLXX/^@=YX^@ GPSoC PCT-Practice Agreement Guidance Amendment History: VersionDateAmendment History0.123/04/08First draft for comment0.202/06/08Amended to take account of comments from the GPC and the GPSoC team and GPSoC Advisory Group review0.312/06/08Amended to take account of comments from the GPC and DH Primary Care Branch1.018/06/08Approved by GPC and DH Primary Care Branch1.118/07/08Amended to clarify postion with referral of disputes to NHS Litigation AuthorityForecast Changes: Anticipated ChangeWhenReviewers: This document must be reviewed by the following: NameSignatureTitle / ResponsibilityDateVersionKees van Ek Paula Moss Graeme McGowanGPSoC team members29/04/08V0.1GPSoC Advisory GroupSHA, PCT and GP representatives06/06/08V0.2Approvals: This document must be approved by the following: NameSignatureTitle / ResponsibilityDateVersionGPCGeneral Practitioners Committee of the BMAV1.0Steve RowlandsHead of Primary Care Liaison & Contracting, DH Primary Care BranchV1.0Distribution: Local Medical Committees (LMCs) via the BMAs General Practitioner Committee GPSoC Clinical IT System User Group Chairs Strategic Health Authority and Primary Care Trust representatives Published on the GPSoC webpages at www.nhsconnectingforhealth.nhs.uk/gpsoc Document Status: This is a controlled document. Whilst this document may be printed, the electronic version maintained in FileCM is the controlled copy. Any printed copies of the document are not controlled. Contents  TOC \o "1-3" \h \z \u  HYPERLINK \l "_Toc201619483" 1 About this Document  PAGEREF _Toc201619483 \h 5  HYPERLINK \l "_Toc201619484" 1.1 Purpose  PAGEREF _Toc201619484 \h 5  HYPERLINK \l "_Toc201619485" 1.2 Audience  PAGEREF _Toc201619485 \h 5  HYPERLINK \l "_Toc201619486" 1.3 Content  PAGEREF _Toc201619486 \h 5  HYPERLINK \l "_Toc201619487" 2 Introduction  PAGEREF _Toc201619487 \h 5  HYPERLINK \l "_Toc201619488" 3 FAQs  PAGEREF _Toc201619488 \h 6  HYPERLINK \l "_Toc201619489" 4 Explaining the Key Clauses in the PCT-Practice Agreement  PAGEREF _Toc201619489 \h 9  HYPERLINK \l "_Toc201619490" 4.1 Definitions  PAGEREF _Toc201619490 \h 9  HYPERLINK \l "_Toc201619491" 4.2 Background  PAGEREF _Toc201619491 \h 9  HYPERLINK \l "_Toc201619492" 4.3 Mutual Responsibilities of the Parties  PAGEREF _Toc201619492 \h 10  HYPERLINK \l "_Toc201619493" 4.4 PCT Responsibilities  PAGEREF _Toc201619493 \h 11  HYPERLINK \l "_Toc201619494" 4.5 Practice Responsibilities  PAGEREF _Toc201619494 \h 11  HYPERLINK \l "_Toc201619495" 4.6 Escalation and Dispute Resolution  PAGEREF _Toc201619495 \h 11  HYPERLINK \l "_Toc201619496" 4.7 Force Majeure  PAGEREF _Toc201619496 \h 12  HYPERLINK \l "_Toc201619497" 4.8 Termination of this Agreement  PAGEREF _Toc201619497 \h 12  HYPERLINK \l "_Toc201619498" 4.9 Variations  PAGEREF _Toc201619498 \h 13  HYPERLINK \l "_Toc201619499" 5 Customising the PCT-Practice Agreement  PAGEREF _Toc201619499 \h 13  About this Document Purpose The purpose of this document is to explain the rationale behind the content of the GPSoC PCT-Practice Agreement and to provide guidance for implementing these Agreements locally. This document explains but does not override the provisions of the PCT-Practice Agreement. Audience This document has been written for Practices and PCTs. Content This document comprises this following sections / topics Introduction - provides some background about the PCT-Practice Agreement FAQs addresses some of the key questions about entering into the PCT-Practice Agreement Explaining the key clauses in the PCT-Practice Agreement the Agreement was developed and agreed with GP, PCT and SHA representatives, this section describes the rationale behind the key clauses in the Agreement. Customising the PCT-Practice Agreement identifies the sections of the Agreement that need to be customised for local use, some of which need to be completed before the Agreement can be signed. Introduction One of the recurring themes during the development of the GPSoC Agreements was the need for clarity about how suppliers, PCTs and Practices would be obliged to fulfil their responsibilities to one another. The GPSoC Framework and Call Off Agreements clarify the supplier, NHS CFH and PCT responsibilities in the supply of GP IM&T services. The PCT-Practice Agreement has been developed to clarify the responsibilities of the PCT and the Practice to each other for the delivery and receipt of IM&T services. NHS Connecting for Health worked closely over many months with the General Practitioners Committee of the BMA, chairs of the GP system user groups and PCT and SHA representatives to develop the Agreement. The Agreement was formally approved by the GPC and SHA Chief Information Officers in early 2008. The diagram below shows how the three GPSoC Agreements relate to each other.  INCLUDEPICTURE "http://www.connectingforhealth.nhs.uk/systemsandservices/gpsupport/gpsoc/elements/contracts/threeagreement.png" \* MERGEFORMATINET  1. GPSoC Framework Agreement NHS CFH and each GPSoC Framework supplier sign a  HYPERLINK "http://limi:2999/npfit/systemsandservices/gpsupport/gpsoc/news/downloads/Version-1-0.doc" \o "Version 1 Framework Agreement" Framework Agreement which contains the bulk of the terms and conditions under GPSoC. The Framework Agreement governs all national requirements for the GPSoC services and includes a Call Off Agreement that enables PCTs to contract with the GPSoC Framework suppliers. 2. GPSoC Call Off Agreement Each PCT and each GPSoC Framework supplier supplying systems to Practices in the PCT sign a  HYPERLINK "http://limi:2999/npfit/systemsandservices/gpsupport/gpsoc/news/downloads/Version-1-4.doc" \o "Version 1.4 Call Off Agreement" Call Off Agreement which governs the local arrangements for the delivery of the supplier's GPSoC Compliant system and associated services. Rather than have separate contracts for each Practice, all Practices that have a GPSoC Compliant system from a GPSoC Framework supplier will be included in the same Call Off Agreement. Each Practice's specific requirements will be detailed in the Call Off Agreement. 3. PCT-Practice Agreement Each Practice and PCT sign a  HYPERLINK "http://limi:2999/npfit/systemsandservices/gpsupport/gpsoc/news/downloads/Version-2-PCT.doc" \o "Version 2 PCT-Practice Agreement" PCT-Practice Agreement which has been introduced to protect the Practice's right to a choice of system and to ensure that the Practice and PCT meet their obligations to each other in respect of the use and delivery of IM&T services. Figure  SEQ Figure \* ARABIC 1 The Three GPSoC Agreements FAQs Who needs to sign up to a PCT-Practice Agreement? Every Practice whose GP clinical IT system is provided through a GPSoC Call Off Agreement needs to sign a PCT-Practice Agreement with its local PCT. Only PCTMS providers are exempt (as the provider is the PCT) from signing a PCT-Practice Agreement. GMS, PMS and APMS Contractors will need to sign the Agreement on behalf of their Practice. What are the benefits of signing a PCT-Practice Agreement? Practices will benefit from greater clarity about what a PCT is required to deliver in respect of IM&T and the service levels that they can expect the PCT to adhere to. PCTs will have a means of holding Practices to their obligations in respect of proper use and maintenance of IM&T services. This Agreement, once signed, introduces a formal dispute resolution procedure which either party can call on to resolve disputes relating to the IM&T matters set out in the PCT-Practice Agreement. This is a new provision which does not exist under current nGMS arrangements for IM&T. What happens if a Practice does not sign up to the PCT-Practice Agreement? If a Practice chooses not to sign the PCT-Practice Agreement, their GPSoC services will no longer be funded by NHS CFH under the GPSoC contractual arrangements. The Practices GP clinical IT system will need to be funded locally, to the detriment of the local health economy. What is the deadline for signing PCT-Practice Agreements? We recognise that local circumstances will differ and so PCTs have been asked to agree deadlines for signature locally in consultation with their Strategic Health Authority. It is in the Practices and PCTs interest to sign an Agreement as soon as possible to ensure that each party is clear about their obligations. Progress will be monitored using the Tracking Database. What about Practices whose systems are provided by their Local Service Provider (LSP)? Once the GPSoC PCT-Practice Agreement has been implemented successfully we will look to develop an equivalent agreement for Practices that use systems provided by their LSP. Does a Contractor (GP) need to be regarded as a Health Service Body before signing up to the PCT-Practice Agreement? No. However, if the Contractor wishes to use the NHS Litigation Authority (Appeal Unit) for dispute resolution then they will need to be a regarded as a Health Service Body (i.e. their GMS, PMS, APMS Contract will be an NHS contract) either at the time of signing the PCT-Practice Agreement (and that status must not have changed) or, before the event that led to the dispute resolution procedure being invoked occurred (if at the time the PCT-Practice Agreement was signed the Contractor was not regarded as a Health Service Body). Paragraph  REF _Ref201619163 \r \h  \* MERGEFORMAT 4.6 below provides more detail about dispute resolution using the NHS Litigation Authority or expert determination. How does a Contractor come to be regarded as a Health Service Body? GMS and PMS Contractors have the right to be regarded as a Health Service Body under regulation 10 (part 4, page 17) of the NHS (General Medical Services Contracts) Regulations 2004 as amended or regulation 9(part 4, page 16) of the NHS (Personal Medical Services Agreements) Regulations 2004 as amended. APMS Contracts can only be NHS contracts if the legal entity holding the Contract already holds an NHS contract for other purposes or if it is one of those bodies detailed in section 9(4) of the National Health Service Act 2006. Whenever the Contractor is regarded as being a Health Service Body its GMS Contract/PMS Agreement will be an NHS contract. Whenever the Contractor is not regarded as a Health Service Body its GMS Contract/PMS Agreement will not be an NHS contract. Note that only disputes involving an NHS contract can be referred to the NHSLA. A Contractor is allowed to ask the PCT to change their status from, or to, that of being regarded as a Health Service Body at anytime, there is no limit on the number of changes that can be requested The status of a GMS or PMS Contractors existing contract/agreement can be varied at any time by the Contractor writing to the PCT as follows: "Dear (CEO/Director of Primary Care) Pursuant to EITHER regulation 10(4) of the NHS (General Medical Services Contracts) Regulations 2004 as amended OR regulation 9(4) of the NHS (Personal Medical Services Agreements) Regulations 2004 as amended (delete as appropriate) I/we wish to request a variation to my/our GMS Contract/PMS Agreement. I/We wish to be regarded as a Health Service Body and understand that our contract will be varied so that it becomes an NHS contract". or, "Dear (CEO/Director of Primary Care) Pursuant to EITHER regulation 10(4) of the NHS (General Medical Services Contracts) Regulations 2004 as amended OR regulation 9(4) of the NHS (Personal Medical Services Agreements) Regulations 2004 as amended (delete as appropriate) I/we wish to request a variation to my/our GMS contract/PMS agreement. . I/We no longer wish to be regarded as a Health Service Body and understand that our contract will be varied so that it is no longer an NHS contract. Explaining the Key Clauses in the PCT-Practice Agreement The responsibilities in the PCT-Practice Agreement generally come from one of these two sources: Existing PCT and Practice responsibilities. The Agreement draws on existing good practice across the NHS and clarifies what the PCT and Practice should do to ensure efficient delivery and use of IM&T. Responsibilities required to ensure the smooth running of the GP clinical IT system. The GPSoC suppliers require that PCTs and Practices do certain things to support the delivery of their services. These responsibilities are listed in Schedule 8 of the Framework Agreement and are reflected in the relevant parts of the PCT-Practice Agreement. The PCT-Practice Agreement is available to download at  HYPERLINK "http://www.nhsconnectingforhealth.nhs.uk/gpsoc" www.nhsconnectingforhealth.nhs.uk/gpsoc. Here is a summary of some of the key clauses in each section of the Agreement: Definitions The definitions of Contract and Contractor exist to confirm that the PCT-Practice Agreement can be used by a GMS, PMS or APMS Contractor but not a PCTMS provider. A number of definitions, such as the GPSoC Framework Core Hours and Severity Level, are copied from the Framework Agreement with the suppliers. Suppliers will need to be able to access Practice premises to resolve critical issues (Severity 1 or 2) outside the GPSoC Framework Core Hours. The definition of Services is used to make it clear that the PCT-Practice Agreement applies to the managed IM&T services provided by the PCT and the GP clinical IT system provided through GPSoC. Background We have tried to ensure that there is no overlap with the standard provisions of the existing GMS, PMS or APMS Contracts. However, in the case of a conflict between the PCT-Practice Agreement and the relevant Contract, Clause 2.7 makes it clear that the GMS, PMS or APMS Contract will take precedence. To provide clarity, the PCT and Contractor should either agree to amend any non-mandatory clauses in their PMS or APMS Contract where there is an overlap with the PCT-Practice Agreement or email  HYPERLINK "mailto:gpsoc@nhs.net" gpsoc@nhs.net to request that a change to the PCT-Practice Agreement be considered. Clause 2.8 sets out the general principles about responsibilities for costs. Mutual Responsibilities of the Parties The section on Services is intended to help the PCT and Practice prepare an agreed list of services that the PCT provides and identify the level of support that will be provided for any additional software and/or hardware that the Practice may have purchased itself. Clauses 3.6-3.11 require the Practice to seek the PCTs permission to install additional hardware, software or take part in testing or pilot activities which involve changes to the software or hardware configuration in the Practice. The PCT is expected to act reasonably and take account of the list of third party software approved by the GP clinical IT system supplier when it makes its decisions. Where a Practice installs software and/or hardware that is not approved by the PCT, clause 3.12 makes it clear that the Practice will be responsible for the costs resulting from the problems caused by their actions. The section about Service Reviews is intended to introduce the good practice of reviewing the services received by a Practice at least once a year. It is up to the PCT and Practice to agree whether they need a Service Review and to agree whether it will be face to face, on the telephone or by an exchange of emails. The section on the Choice of GP Clinical IT System reflects the paragraphs in the New GMS Contract 2003 (Investing in General Practice) the Blue Book - about a Practices choice of system and sets out the steps for agreeing a change of system where a Practice wishes to migrate to an alternative GP Clinical IT system. Where the PCT requires a business case for the change there is a template for preparing a business case in Appendix 4 to the PCT-Practice Agreement. The sections on Business Continuity and Disaster Recovery and Training require the Practice to develop plans which, once they have been agreed by the PCT, govern what each party needs to do and fund. The sections on Confidentiality and Data Protection reflect good practice and legal requirements on both parties. PCT Responsibilities This section sets out the PCTs specific responsibilities to: contract for a GPSoC Compliant System on behalf of the Practice; provide and support software and IT infrastructure; meet the Support & Maintenance Service Levels that the PCT has set out in locally agreed Appendix 2 of the PCT-Practice Agreement; provide support during system upgrades and migrations; and ensure that other bodies who provide services on behalf of the PCT, e.g. a Health Informatics Service, are made aware of the responsibilities they must fulfil on behalf of the PCT under the terms of the PCT-Practice Agreement. Practice Responsibilities This section sets out the Practices specific responsibilities to: work with the PCT and follow suppliers guidelines for the use of their systems; comply with software licence requirements and use, update and store software and hardware in a suitable way; follow agreed procedures for hardware and software support; undertake actions to support upgrades to the Practices system or during migration to an alternative system; and provide contact details and access to premises as required and implement security measures to protect equipment from theft. Escalation and Dispute Resolution Practices and PCTs are encouraged to establish local points of escalation to resolve disputes relating to the delivery of IM&T services. The purpose of the PCT-Practice Agreement is to clarify responsibilities and reduce the incidence of disputes. Where a PCT and Practice cannot resolve a dispute locally the PCT-Practice Agreement offers two routes for independent dispute resolution: NHS Litigation Authority In order to refer disputes to the NHS Litigation Authority, the Contractor must be regarded as a Health Service Body (i.e. their GMS, PMS or APMS Contract will be an NHS contract) see  HYPERLINK \l "_FAQs" FAQs. Where a Contractor changes their Health Service Body status after signing the PCT Practice Agreement, an important question when deciding how the dispute will be handled will be the timing of the change of status vis-a-vis the matter in dispute. Advice is offered in the FAQs, but it must be noted by all concerned that the decision on whether a dispute falls within the remit of the NHSLA will rest with the NHSLA. The PCT and Practice should forward details of the dispute to the NHS Litigation Authority (Appeal Unit) in Harrogate: The Chief Officer NHS Litigation Authority (Appeal Unit) 30, Victoria Avenue, Harrogate, HG1 5PR The Appeal Unit is funded by the Department of Health, however each party will be responsible for their own costs in bringing the dispute. A Secretary of State Direction is due to be issued to the NHS Litigation Authority to formalise this arrangement. In the meantime, where the PCT-Practice Agrement is an NHS Contract, disputes can still be raised directly with the NHS Litigation Authority who can act on behalf of the Secretary of State for Health. Expert Determination Where the Contractor is not regarded as a Health Service Body (i.e. their Contract is not an NHS contract), disputes cannot be referred to the NHSLA and may be heard by an independent Expert, BCS or Chairman of the Law Society of England and Wales. Depending on the issue, the Expert may be an IM&T lead from a different PCT, a GP, a lawyer or a technical expert. The parties will be liable for the costs of Expert Determination and their own costs. The GPCs advice is that where a GMS/PMS Contractor is not regarded as a Health Service Body they should write to their PCT seeking such status before signing the PCT-Practice Agreement so as to be able to refer disputes to the NHS Litigation Authority instead of using Expert Determination. Force Majeure This section sets out the circumstances in which the PCT or the Practice can claim for relief from their obligations due to a Force Majeure Event. Termination of this Agreement The PCT-Practice Agreement is an integral part of the GPSoC contractual arrangements. Therefore, any Practice that is receiving services under a GPSoC Agreement needs to have signed a PCT-Practice Agreement. This section sets out the circumstances in which the PCT-Practice Agreement may be terminated. The PCT will need to notify NHS CFH within 5 days of a termination so that the necessary changes can be made to the GPSoC Framework and Call Off Agreements. Variations There are specific parts of the PCT-Practice Agreement that may be customised for local use. These are listed in the  REF _Ref196721569 \h Table 1 below. All other sections of the PCT-Practice Agreement are standard for all PCTs and Practices. This is largely because the responsibilities in the PCT-Practice Agreement need to remain aligned with the responsibilities on the PCT and Practice that have been agreed with the GPSoC Suppliers. If a PCT or Practice requires a change to the Agreement they should contact NHS CFH at  HYPERLINK "mailto:gpsoc@nhs.net" gpsoc@nhs.net. Customising the PCT-Practice Agreement We recognise that there are a number of arrangements that should be agreed locally to suit the circumstances in a particular Practice or PCT. The elements of the PCT-Practice Agreement that can be customises are listed in Table 1 below. The table also identifies which documents need to be completed prior to signing the PCT-Practice Agreement. The expectation is that these local variations will be agreed between the PCT and local Practices. Where PCTs or Practices have difficulties with reaching Agreement they are welcome to contact the GPSoC team at  HYPERLINK "mailto:gpsoc@nhs.net" gpsoc@nhs.net for guidance about how other areas have dealt with the same issues or to seek advice from other trusted parties. PCT-Practice Agreement RefDocumentActionTimingClause 3.23Business Continuity and Disaster Recovery PlanPractice to produce, PCT to agree content and responsibilities.Not a pre-requisite for signing the Agreement. Ideally produce and update at least once a year.Clause 3.32Training Needs AnalysisPractice to produce.Clause 3.33Training PlanPractice to produce, PCT to agree content and responsibilities.Clause 3.38Record of Staff TrainingPractice to produce.Clause 5.23Contact details for primary and secondary contact for service issuesPractice to provide to PCT. PCT to provide to suppliers as required.Prior to signing PCT-Practice AgreementAppendix 1Summary of ServicesPCT to produce and agree with each Practice. GPSoC Schedules A, A(i) and B provide details of GPSoC Services.Prior to signing PCT-Practice AgreementAppendix 2Support and Maintenance Service LevelsPCT to produce to reflect local circumstances and capability. Guidance provided in embedded document in Appendix 2.Prior to signing PCT-Practice AgreementAppendix 3Escalation ProcedurePCT to produce and agree with the Practices. Guidance provided in embedded document in Appendix 2.Not a pre-requisite for signing the Agreement. Ideally produce and agree within 3 months of signature. Appendix 4Business Case for Migration of a GP Clinical IT SystemPractice to produce with input from the PCT. PCT to approve (or not) as appropriateOnly required if a Practice wishes to migrate to an alternative system and the PCT requests a business case.Appendix 5List of Prohibited Software and HardwarePCT to producePrior to signing PCT-Practice AgreementPage 24 Agreement Signature PageBoth parties to sign the AgreementAt signatureTable  SEQ Table \* ARABIC 1 Customising the PCT-Practice Agreement Summary of Documentation     GPSoC PCT-Practice Agreement Guidance NPFIT-PC-PMG-DEL-0051.03 18/07/08/ Approved / V1.1 Crown Copyright  DATE \@ "yyyy" \* MERGEFORMAT 2008 Page  PAGE 14 of  NUMPAGES 14 GPSoC PCT-Practice Agreement GuidanceProgrammeNPFITDocument Record ID KeySub-Prog / ProjectGPSoCNPFIT-PC-PMG-DEL-0051.03Prog. 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