SECTION 1: INTRODUCTION NHAIS News Issue Date CCG Co-commissioning... 2 SECTION 2: GP PAYMENTS... 2

Transcription

1 NHAIS News In this issue... Issue 67 Octber 2015 SECTION 1: INTRODUCTION NHAIS News Issue Date CCG C-cmmissining... 2 SECTION 2: GP PAYMENTS New GP Payments functinality issued frm 31 July t 30 September T/14897 Released t all sites n 18 August. This has issued three new DES Paycdes recrding payment fr Out f Area Registratin In hurs urgent care, plus a minr change t the Paycde fr Halcn, changing this frm ZHALCOA t ZHALCO T/14798 Released t all sites n 5 August. This issued CR5815 mdificatins t the EM screen, Paycde/*VAL ptin which defines duplicate claim validatin rules impsed n Practice input (via Open Exeter) f DES/LES claims. This nw includes the ptin t extend duplicate checking acrss all GP Practices n the Agency System T/14878 Released t all sites n 5 August. This sent ut a revised PSAU4552/1.10 which issued six new GMS, PMS and APMS Paycdes fr Meningitis B and Meningitis ACWY DES claims submitted via CQRS New GP payments items currently under develpment CR5871 This change has been raised in respnse t the NHS Pensins intrductin f the Early Retirement Reductin Buy-ut Optin (ERRBO) scheme, and prpses mdificatins t NHAIS applicatins recrding GP Pensin returns Outstanding New GMS Payments System enhancements apprved by NHS England Further additinal infrmatin Change Requests raised since 1 June 2015 plus nging wrk and delivered items... 6 Cpyright Health and Scial Care Infrmatin Centre

2 Sectin 1: Intrductin 1.1 NHAIS News Issue Date T HE OCTOBER 2015 ISSUE OF NHAIS NEWS was sent t the Health and Scial Care Infrmatin Centre website n 1 Octber and carries within it details f all SIS Upgrades issued frm 31 July t 30 September Details f SIS Requests issued frm 1 Octber nwards will be within the fllwing (December 2015) editin f NHAIS News. 1.2 CCG C-cmmissining Plans are in place fr the intrductin f CCG C-cmmissining frm April GP Payments Develpment Staff are wrking t design and build additinal NHAIS functinality t supprt direct CCG funding f nminated services. The intentin is t prvide these new prcesses in time fr rll-ut f CCG C-cmmissining next year. This prvisin shuld ensure that n additinal wrklad implicatins are assciated with this change t business prcesses. Sectin 2: GP Payments 2.1 New GP Payments functinality issued frm 31 July t 30 September T/14897 Released t all sites n 18 August. This has issued three new DES Paycdes recrding payment fr Out f Area Registratin In hurs urgent care, plus a minr change t the Paycde fr Halcn, changing this frm ZHALCOA t ZHALCO PSAU4552/1.11 was issued t all English sites n 18 August t install three new Paycdes, FIMS and Subjective Cdes as fllws: Paycde GMS/ PMS Paycde Descriptin FIMS Line N. Subjective Cde IHRUCA P C&M-APMS DES OOAR in hrs urgentcare IHRUCG G C&M-GMS DES OOAR in hrs urgentcare IHRUCP P C&M-PMS DES OOAR in hrs urgentcare V VQ WA Table 1: New Paycdes, FIMS and Subjective Cdes (PSAU 4552/1.11) This update respnded t a request frm NHS England fr these additinal DES payments, generated thrugh CQRS. The pprtunity was als taken t crrect the seven character cde fr APMS HALCON, ZHALCOA t make this instead 6 character, ZHALCO. This upgrade was nt applied t Welsh sites r the Isle f Man, wh d nt use CQRS. 2 Cpyright Health and Scial Care Infrmatin Centre 2015

3 These changes were applied t GP Payments n English NHAIS systems frm 19 August T/14798 Released t all sites n 5 August. This issued CR5815 mdificatins t the EM screen, Paycde/*VAL ptin which defines duplicate claim validatin rules impsed n Practice input (via Open Exeter) f DES/LES claims. This nw includes the ptin t extend duplicate checking acrss all GP Practices n the Agency System SIS T/14798 was issued t all sites n 5 August. This has installed changes t the EM Paycde/*VAL screen as requested by CR5815. CR5815 was raised t request ptinal additinal validatin t reject duplicate DES/LES claim input if the same claim fr the same patient has been submitted by anther GP Practice; s validatin is nt just limited t within the same GP Practice. The EM, Paycde/*VAL screen has been amended t include tw new ptins: Extend duplicate and claim perid verlap check t all practices (Y r blank) If this ptin is set t Y, the duplicate validatin rules (defined n the EM Paycde/*DUP screen) will be applied t new claims fr the paycde. All existing claims fr the paycde and NHS number will be checked n the NHAIS system. If a duplicate claim is fund fr a different practice than the claiming practice the claim will be rejected. If this ptin is blank, the duplicate validatin rules will nly check fr existing claims submitted by the claiming practice. Include extended paycdes fr all practices (Y r blank) If this ptin is set t Y, the additinal paycdes input against Extend duplicate and claim perid verlap check t the fllwing Paycdes: will als be checked t see if a duplicate exists fr any f the paycdes, fr the NHS number, within any practice. If this ptin is blank, the duplicate validatin rules fr checking extended paycdes will nly check fr a duplicate claim with the same paycde by the same GP Practice. Cpyright Health and Scial Care Infrmatin Centre

4 The revised EM screen layut, shwing the new ptin selectins highlighted in bld is shwn belw: EM]Direct/Lcal Enhanced Services Qualifier[ALCHG/*VAL ] ALCOHOL - Claims Based (Individual) Extend duplicate and claim perid verlap check t the fllwing Paycdes: [ALCHP ] [ ] [ ] [ ] [ ] [ ] [ ] Extend duplicate and claim perid verlap check t all practices (Y/blank). [Y] Include extended paycdes fr all practices (Y/blank) [Y] The type f duplicate check perfrmed is gverned by parameters entered t (r mitted frm) the EM Paycde/*DUP screen fr the selected Paycde (e.g. FLU1 in the example screen). The default is same day/same patient duplicate checking, unless specific (Qualifier nly) Paycde/*DUP parameters are entered. Gender Restrictin n Claims Submissin (M/F) (null is n validatin)... [ ] Minimum age f Patient n Claim Date (Years) (null is n validatin)... [16 ] Maximum age f Patient n Claim Date (Years) (null is n validatin)... [ ] Fixed date fr calculating patient's age (instead f claim date).. [ ] Maximum claims allwable against a single date/patient/incident [1 ] Figure 1: EM screen, revised t perfrm duplicate validatin checks acrss practices T/14878 Released t all sites n 5 August. This sent ut a revised PSAU4552/1.10 which issued six new GMS, PMS and APMS Paycdes fr Meningitis B and Meningitis ACWY DES claims submitted via CQRS SIS T/14878 was sent t all English sites (excluding Wales and IM) n 5 August t install additins t the file f valid Paycdes, requested by NHS England t supprt additinal CQRS payments. The SIS released PSAU4552/1.10 which installed six new Paycdes, FIMS and Subjective Cdes as fllws: Paycde GMS/ PMS Paycde Descriptin FIMS Line N. Subjective Cde MENCBA P C&M-APMS DES Men B V0 MACWYA P C&M-APMS DES Men ACWY V1 MENCBG G C&M-GMS DES Men B VN MACWYG G C&M-GMS DES Men ACWY VP MENCBP P C&M-PMS DES Men B W8 MACWYP P C&M-PMS DES Men ACWY W9 Table 2: New Paycdes, FIMS and Subjective Cdes (PSAU 4552/1.10) This upgrade has nt been applied t Welsh sites r the Isle f Man, wh d nt use CQRS. These changes have been applied t GP Payments n English NHAIS systems frm 6 August Cpyright Health and Scial Care Infrmatin Centre 2015

5 2.2 New GP payments items currently under develpment CR5871 This change has been raised in respnse t the NHS Pensins intrductin f the Early Retirement Reductin Buy-ut Optin (ERRBO) scheme, and prpses mdificatins t NHAIS applicatins recrding GP Pensin returns Intrductin f the 2015 NHS Pensin Scheme in April this year replaces the fixed NPA (Nrmal Pensin Age) f 60 years fr the 1995 Scheme r 65 years fr the 2008 Scheme, with a variable NPA which aligns t the SPA (State Pensin Age) as at date f retirement. This means that fr 2015 Scheme members their nrmal date f retirement (the age at which they can draw an unabated NHS Pensin) will increase during the next decades, initially rising frm 65 t 66 years between Nvember 2018 and Octber Further increases in SPA are planned, t rise frm 66 t 67 years frm 2026 thrugh t 2028 and again frm 67 t 68 years frm 2044 t These changes will under current NHS Pensins Legislatin als increase the Nrmal Pensinable Age (NPA) at which an unabated pensin can be drawn under the 2015 NHS Pensins Scheme. NHS Pensins recgnise the ptential impact f these changes n members and have intrduced a new buy-ut ptin, applicable and available nly within the 2015 Scheme. This buy-ut (ERRBO) invites members t purchase the ptin f aviding pensin abatement, shuld they decide t retire early (at age 65, 66 r 67) instead f at SPA which will eventually rise t 68. CR5871 has been raised in respnse intrductin f ERRBO and requests mdificatin t the Payments System t accmmdate deductin and recrding f ERRBO cntributins. It is planned that this will be achieved by intrductin f a new superannuatin Paycde. Additinal mdificatins are required t Payments System Superannuatin screen applicatins, GB, GA, GQ and EY; Superannuatin prcessing n FJ-EYOR; variance recrding n EV and FJ-EVPB and payments prcessing n FJ-NMPP and assciated EZ display screen. There are als assciated implied mdificatins t Open Exeter Statement Display. High level design t scpe individual applicatins changes is already in prgress with wrk n individual mdules anticipated t start early this mnth (Octber). Target cmpletin is later this year, with pilt trial scheduled t cmmence in December Outstanding New GMS Payments System enhancements apprved by NHS England There are currently n utstanding New GMS Payments System enhancements, apprved and awaiting start f develpment by the GP Payments Team. Cpyright Health and Scial Care Infrmatin Centre

6 2.4 Further additinal infrmatin Change Requests raised since 1 June 2015 plus nging wrk and delivered items New CRs: n new CRs have been raised and apprved since the August newsletter. CR5871 This change was raised in August and respnds t NHS Pensins intrductin f the Early Retirement Reductin Buy Out (ERRBO) scheme. This will apply t members f the 2015 NHS Pensin Scheme. The 2015 scheme ties NHS retirement t State Pensinable Age (SPA). SPA is currently set t rise t 66 frm Nvember 2018, increasing t 67 frm 2026 and 68 frm The ERRBO scheme prvides the ptin fr members f the 2015 scheme t claim their NHS Pensin early (at age 65, 66 r 67) withut suffering abatement, in return fr additinal vluntary cntributins t the 2015 scheme. See als sectin f this newsletter Existing CRs in prgress: ne CR5871 Wrk is nw prgressing n the verall design specificatin f this change, which will require mdificatins t several areas f superannuatin prcessing. Develpment is anticipated t cntinue thrughut Octber and Nvember this year with pilt trial t cmmence in mid-december. See als sectin f this newsletter CRs nw cmpleted: ne CR5815 This change t the EM screen and validatin cntrlling Open Exeter input f DES/LES claims by GP Practices prvides the ptin t extend claim duplicate checking acrss all GP Practices n the hst NHAIS System. This change was issued natinally n August 5 fllwing extensive pilting at the requesting Welsh site. The change was distributed by SIS T/ See als sectin f this Newsletter Existing CRs currently under review: ne CR5772 T prvide a screen facility t summarise all end f year data, nce submitted and maintain an annual recrd f submissins cmpleted in each year and autmatically update the EY screen with clsed status. Under Review 6 Cpyright Health and Scial Care Infrmatin Centre 2015

7 Apprved utstanding CRs: nne. Rejected CRs: nne. Cpyright Health and Scial Care Infrmatin Centre