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The GP patient access survey was developed in consultation with the Scottish General Practitioners Committee and the Royal College of General Practitioners, and was cognitively tested by IPSOS Mori on members of the public. The questionnaire was sent to a completely random sample of adults registered with each GP practice in Scotland. Only patients who said they had tried to make the relevant contact in the past 12 months were included in the calculation, and any incomplete or erroneous responses were excluded.

Quality and Outcomes Framework (QOF) payments made to Scottish GP practices for the 2008-09 year totalled approximately £128 million, compared with approximately £131 million for 2007-08. The overall reduction in payments was as a consequence of a series of changes made to the structure of the QOF between those two years. These changes included, but were not limited to, the use of the 2008-09 GP patient access survey.

The table below provides detail on payments associated with different parts of the QOF for 2007-08 and 2008-09. It is based on data for 996 Scottish General Practices that were open in both years and for which detailed comparable payments data are held centrally.

The two QOF indicators that were derived from the 2008-09 GP patient access survey (PE07 and PE08) had between them up to 58.5 QOF points available to each GP practice. This compares with 20 points available for a previous patient experience survey indicator (PE05) included in the 2007-08 QOF. Across 996 Scottish GP practices for which we can directly compare detailed payments information for 2007-08 with 2008-09, payments for this part of the patient experience domain of the QOF increased by approximately £2.5 million.

However, other indicators were removed from the 2007-08 QOF and the points that were previously available for these indicators were redistributed to the new PE07 and PE08 patient survey indicators. Many practices had achieved very high scores against the indicators that were removed, such as the holistic care bonus, which rewarded practices for consistently high achievement against clinical indicators (those covering health conditions such as diabetes, CHD and hypertension). The loss of practice income previously associated with holistic care and other indicators (approximately £4.7 million across the 996 practices compared) was greater than the increase in payments made under the revised patient experience domain of the QOF. This resulted in an overall reduction of approximately £2.2 million in payments to the 996 practices for which detailed comparisons have been made.

Payments for QOF year 2007-08^1,2

Indicator / Group	Points Available	% of Points Achieved	Total Payment
Indicators/points in 2007-08 but removed for 2008-09
PE05	20.0	97.4	£2,574,678
Holistic Care bonus	20.0	95.5	£2,538,798
COPD09 3	5.0	98.9	£636,566
Other indicators removed for 2008/09	13.5	87.6	£1,564,577
Rest of QOF indicators
Indicators in QOF in both 2007-08 and 2008-09	941.5	98.0	£119,962,575
Total for 2007-08 QOF	1,000.0	97.8	£127,277,194
Payments for QOF year 2008-09 1
PE07/PE08	58.5	75.0	£5,060,206
Rest of QOF indicators
Indicators in QOF in both 2007-08 and 2008-09	941.5	98.3	£120,183,378
Total for 2008-09 QOF	1,000.0	96.9	£125,243,584

Notes:

1. Based on data for 996 Scottish General Practices that were open in both years and for which detailed comparable payments data are held centrally. In each of these years the total number of GP practices in Scotland was around 1,015.

2. These figures do not reflect any local or national adjustments that may have been made to practice payments after QOF achievement data for each year were published at:

www.isdscotland.org/qof.

3. COPD09 had 10 points available for 2007-08, reduced to five for 2008-09. In the table shown here, payments associated with five of the COPD09 points in 2007-08 have been shown against COPD09. Payments for the other five points have been included under Rest of QOF indicators to give a like for like comparison with 2008‘09.

The table below shows the number of practices for which total Quality and Outcomes Framework (QOF) payments for 2008-09 (a) increased by 1% or more, (b) changed by less than 1% and (c) decreased by 1% or more relative to 2007-08. No practice received exactly the same QOF payment in both years. The table is based on data for 996 Scottish General Practices that were open in both years and for which detailed comparable payments data are held centrally. For context, in each of these years the total number of GP practices in Scotland was around 1,015.

As explained in question S3W-31402 on 25 February 2010, the overall change in payments made to practices for the 2008-09 year was the product of a number of changes made to the structure of the QOF between 2007-08 and 2008-09, which included, but were not limited to, the introduction of new indicators derived from the 2008-09 GP patient access survey. Detailed information on the QOF points achieved by Scottish general practices in each year is published at www.isdscotland.org/qof.

Change to total QOF Payments between 2007-08 and 2008-09²

NHS Board	Number of Practices1	(a) Increased by 1% or More	(b) Changed by Less than 1%	(c) Decreased by 1% or More
Ayrshire and Arran	59	7	13	39
Borders	25	7	10	8
Dumfries and Galloway	35	5	18	12
Fife	56	10	12	34
Forth Valley	56	13	14	29
Grampian	76	19	26	31
Greater Glasgow and Clyde	271	47	79	145
Highland	102	45	25	32
Lanarkshire	98	14	18	66
Lothian	118	19	36	63
Orkney	12	7	2	3
Shetland	10	0	5	5
Tayside	66	12	18	36
Western Isles	12	7	4	1
Scotland	996	212	280	504

Notes:

1. Based on data for 996 Scottish General Practices that were open in both years and for which detailed comparable payments data are held centrally. In each of these years the total number of GP practices in Scotland was around 1,015.

2. These figures do not reflect any local or national adjustments that may have been made to practice payments after QOF achievement data for each year were published at:

www.isdscotland.org/qof.

All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

The overall response rate to the 2008-09 GP patient access survey was 50%. However, the number of responses that could be used in the calculation of the QOF patient experience of access indicators PE7 and PE8 was less than the number of questionnaires that were returned. This was mainly because people had not tried to access the practice in the way specified.

The results for the QOF indicators were derived from combinations of 3 questions (PE7) and 2 questions (PE8). Therefore, the valid responses for an indicator depended on the sequence of questions being answered, and not just a response rate to a particular question “ which would be higher. For example, those who missed out a question or ticked more than one option in a question were excluded from the analysis for that indicator. The observed valid response rates (as % of the total number sent out) are shown in the following table.

	(a) Mean	(b) Median	(c) Standard Deviation
PE7 (48 hour access)	37%	37%	8%
PE8 (advance access)	23%	24%	6%

 

The procedure for contract dispute resolution is set out in the GP contract regulations, under which the contractor and health board are expected to make every reasonable effort to communicate and co-operate with each other with a view to resolving the dispute. It would not be appropriate for the Scottish Government to issue guidance on this, since such disputes may ultimately be referred to Scottish ministers for decision.

Available Quality and Outcomes Framework funding was the same in 2008-09 as it was in the previous year. Changes in the way some of the points were allocated (as explained in the answer to question S3W-31402 on 25 February 2010) were agreed at the UK level. The payments for indicators on PE7 and PE8 were based on the survey results as stated in the Statement of Financial Entitlement.

All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.

I have asked Willie Pretswell, Interim Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

The Naloxone Randomised Control Trial (N-ALIVE) is due to begin in all Scottish prisons in summer 2010, pending ethical approval, with the exception of HM Prisons Inverness, Dumfries and Edinburgh.

HM Prison Inverness is currently involved in the provision of naloxone in NHS Highland. HM Prisons Dumfries and Edinburgh are planning for the provision of naloxone in NHS Dumfries and Galloway and NHS Lothian respectively.

I have asked Willie Pretswell, Interim Chief Executive of the Scottish Prison Service, to respond. His response is as follows:

The current timeline, subject to legislation, for the commencement of the integration of prison primary medical and nursing services into the NHS is the autumn of 2011. The Chair of the National Programme Board for Prisoners'' Healthcare (NPBPH), Mr John Ross CBE, was appointed by ministers in March 2009 for a period of three years to oversee the transfer of prisoner healthcare to the NHS.

There are no plans at present to amend the guidance in relation to swan neck taps. The current guidance prohibits their installation in new buildings and recommends their replacement in existing premises where they are damaged or faulty. There is no evidence to suggest that the current guidance on risk assessment procedures associated with the management of standing water in facilities where sporadic use is identified is in any way unsatisfactory.

There are regular discussions between the Scottish Government and UK Department of Health on various health related issues. The pilot practice accreditation scheme is a Department of Health initiative linked to quality of care and registration of GP practices with the English Care Quality Commission. In Scotland there is a broadly equivalent Quality Practice Award run by RCGP Scotland which aims to improve patient care by encouraging and supporting practices to deliver the highest quality care to their patients.