GP Practices and CQRS Claims
A GP contract also sets out optional agreements to deliver services in return for additional payments. This includes the nationally negotiated Direct Enhanced Services (DES). DES focuses on clinical indicators that support national priorities and support patient access and experience.
Services outside of national GP contracts are called local enhanced services. They provide a wider range of primary medical services to meet local population needs. Local incentive schemes supplement core services offered by GP practices to meet local population needs and priorities, which are commissioned by Integrated Care Boards (ICBs).
The Calculating Quality Reporting Service (CQRS) is an approval, reporting and payments system for GP practices. It helps practices track, monitor and declare achievement for the Quality and Outcomes Framework (QOF), DES, and Vaccination and Immunisation (V&I) programmes [source NHS Digital]. Since 1 November 2020, CQRS has been managed by the NHS Commissioning Support Units.
Making CQRS Claims
Information from GP practices is automatically collected by CQRS National from practice clinical records system. This is carried out through the General Practice Extraction Service (GPES) or is directly inputted by GP practices for local enhanced services.
For automatic data from GP practice clinical systems, the CQRS National system calculates a Quality Service Achievement based on the data received, and relevant payments are made.
For manually inputted data relating to local enhanced services, CQRS Local is a free, flexible, web based, payment claim system that helps to streamline the management processes associated with local incentive schemes.
Registered GP Practice users log into the CQRS Local portal and follow the easy-to-use screens to submit a claim by:
- Selecting the service and service components
- Inserting details about the claim such as unit values
- Adding attachments as supporting evidence
- Completing supplementary information, if required.
When users submit a claim, it will be validated and then submitted for approval. If the claim fails validation, issues will display in an errors list for correction by the user. If a claim is rejected, the approver will enter a reason which helps ensure future claims are submitted correctly.
Benefits of CQRS
CQRS Local is a web-based portal that enables providers and commissioners to manage claims for locally driven schemes that reflect local priorities. Additionally, it streamlines the process of provider claims against local schemes. It reduces administrative time, and ensures claims are trackable within a secure web-based platform.
Benefits of CQRS Local for GP practices
CQRS Local provides GP practices with flexibility in managing local incentives schemes. It removes the administrative overhead of submitting documented email claims by providing a more straightforward submission process. Furthermore, the system offers the ability to add supporting evidence and track claims. Finally, it reduces the risk of inaccurate claims resulting in prompt payments to GP practices.
Benefits of CQRS Local for commissioners
CQRS Local provides commissioners with a single, central point of access with enhanced reporting functionality. The system helps to reduce the amount of time spent administering local payments. This is achieved through trackable and auditable data submissions from providers and helps to reduce the risk of inaccurate claims.