The possibilities for CQRS Local within Primary Care Networks

Head of GP Payments from NHS South, Central and West Commissioning Support Unit talks about the possibilities for (CQRS) Local within Primary Care Networks.

Deborah Matson-Beale heads up our CQRS Local programme as the Head of GP Payments for NHS South, Central and West CSU.

Prior to this role, she worked as the CEO for a 30,000-patient Primary Care Network (PCN). Therefore Deborah recognises the challenges and possibilities that CQRS Local will create for PCNs to work collaboratively on locally commissioned schemes.

Role of Primary Care Networks

“PCNs are still in their developmental stage, having started to evolve mid-2019. They are tasked to collaboratively bring services specific to their community with other organisations, and with the transition over to integrated care systems will fast track this process. Collaboration includes sharing best practice, integrating IT systems and exchange of information which results in improved efficiencies.”

The COVID-19 pandemic created opportunities for PCNs to start to deliver population-based care at scale. Many PCNs fronted the vaccination rollout, with GP teams delivering around 75% of vaccines. 

Furthermore, PCNs have developed home visiting and minor illness teams, first contact physios, mental health and pharmacy teams to ease GPs’ workload.

Locally commissioned schemes

Locally commissioned schemes have the potential to diversify, and with the prospect of further vaccine rollouts, tackling health inequalities, providing community specialist services and improved cancer diagnosis. All whilst operating within a changing NHS landscape, PCNs will establish their role as a ‘building block’ of integrated care systems (ICSs).

Every ICS will play a critical role in ensuring that PCNs work with other community staff and use multi-disciplinary teams across primary and community care.

There isn’t a limit on the number of local services that can be commissioned on CQRS Local; therefore, different services can be offered to different providers. This can be a single practice as a provider, or a primary care network or extended to new providers.

The use of CQRS Local should not have any impact on local commissioning decisions, and schemes can be independent of other commissioners where different communities will have different population health outcomes and health inequalities.

Instant benefits for Primary Care Networks

There are several pressures in running a start-up PCN, which include keeping up with the latest contractual requirements and translating those requirements into deliverables with staff and the community.

CQRS Local alleviates these pressures for practices by providing a financial assurance that claims will be paid quickly and accurately without the need for a form or email to submit.

This new claim management system reduces the manual processes associated with uploading excel spreadsheets and having to keep a record of claims to be processed. There is visibility in the system to be able to track claims payments and when they have been signed off by the commissioner.  

“CQRS Local provides the ability to customise the set up for data entry and collection of any kind of contractual requirement. Not only is it ideal for managing claims all in one place, that in the past have been collected individually using email and a form, but the status of those claims can now be reported on from CQRS Local.”

This built-in reporting mechanism enables the service user to calculate claims processed over a period, which provides a benchmark for ensuring that targets are being achieved across locally commissioned services.

Future potential for Primary Care Networks

CQRS Local will transform local incentivised schemes for primary care providers and commissioners, opening up other possibilities as new functionality is added.

“It’s a vehicle that will support the ambition of the NHS in the digital age to move fully online to provide an automated end to end service. With its flexible and open structure, anything that requires tracking for payment could be set up within it, including areas that may not have been considered before, such as vaccine stock claiming.

“CQRS Local is starting to test connecting to a payment system and with the ability to already track and report, is on its way to the goal of providing a centralised system for primary care and commissioners to manage their local incentivised schemes.”

With the whole system change required for the implementation of the integrated care partnerships (ICPs) in July, CQRS Local could bring stability in the financial claims area for the commissioners, allowing them to focus on other important changes. 

“Making that move from the GP Primary Care Local Commissioned Services (LCS) manual claim process to the CQRS claim management system will provide a more streamlined process for invoicing mechanisms and could have wider consideration for the ICPs in freeing up time to support other organisations within their community.”