Practice Visit Information

Locality practice visit guidance

Please see below the links for documents that Locality leads will need in order to carry out practice visits in 20010/11:

Document What it is and how to use it Where to find it
PBC budget and Expenditure Report What is it?Gives the most recent overall Lambeth financial position plus the individual practice position.  It details total PBC budgets and the prescribing and acute element only by practice and grouped into Localities.How to use it

  1. Check with the practice that they regularly see and review the report
  2. Outline the overall PCT financial position, outlined in the first paragraph
  3. Highlight the practice position in appendix B and C – the variance % column is probably most useful.  This will show how over/under spent the practice is and give you a basis on which to start the discussion 
Month 5 data can be found here: Month 5 budget and expenditure reportFor the most recent version please contact Philip.cokayne@lambethpct.nhs.ukPlease note that Appendix A details the practice individual budget.  A copy of this for any practice can also be obtained by contacting Phil.
Summary of PBC Budgets and Expenditure What is It?Gives an explanation of budget setting methodology, adjustments to list sizes and a breakdown of the financial position for that month by consortium and by mode of delivery (i.e. elective, non-elective etc).  Also breaks down activity so that you are able to look at practice targets for GP initiated first outpatient appointments which PBC plans and the PBC delivery scheme are based on.How to use it

  1. Useful for answering generic questions on budget setting methodology so keep this on hand for reference
  2. Go to Appendix B.  This has two tables; one for activity and one for finance for GP initiated first outpatients only.  You should identify the level of performance for the practice by using the % variance over/underspend for that month AND the forecast year-end over/under performance.
  3. Discuss the practice position ensuring that they understand how they are performing and how this compares to the locality as a whole
  4. Go to appendix F.  This gives a position for each Locality and gives performance against other modes of delivery.  You should review where the Locality does well as a whole and how the practice compares to this.
Month 5 data can be found here: Summary of Month 5 budget and expenditureFor the most recent version please contact
PBC actions plan for the practiceBSU assessment of plans by Locality What is It?The practice’s final submission for their PBC action plan which outlines actions that the practice intends to take to meet (or progress towards) the targets for GP initiated first outpatient reduction as discussed using the documents above.  Also a brief summary of the BSU assessment of the plan.How to use it

  1. Discuss with the practice how far they are in implementing their actions and how impact is being monitored by the practice (both should be in the plan)
  2. Discuss any areas highlighted by the BSU that the practice may want to consider.
  3. Discuss any learning needs or support the practice requires either in developing these sorts of plans (and especially in quantification of impact) and in implementing practice actions.
  4. Discuss with the practice how far their actions are going to address their level of performance that you will have discussed in (2)
Contact the following people for a copy of the practice action plan and the BSU assessment of plans by Locality:South East Gillian.ellsbury@nhs.netSACH: jim.stock@nhs.netNorth:
Resources available to practices to help manage demand What is It and how to use it

  1. Results of PBC audits – summary of the four audits that Lambeth PBC carried out during 2010/11.  Gives 4 graphs which show where the practice sis compared to other Lambeth practices.  You should discuss with the practice their average referral rate PLUS the % level of opportunity for some of this activity to be managed in primary care.  If there is opportunity in either, it should be in the practice action plan with realistic actions as to how to monopolise on the opportunity.
  2. Overview of practice level referral rates across Lambeth – an overall idea of how the practice performs across the board (i.e. not specific to one or more specialties).  Used as above.
  3. Hints and tips for practices in managing demand in practice – gives ideas from other practices on actions that can be taken.  You should discuss this with practices if there is anything they can learn from these examples.
  4. List of alternative services to secondary care – you should encourage practices to ensure that all referring clinicians are aware of this list, either electronically or on paper.
  5. Overview of outpatient activity from Xiom (if the practice or Locality has it)
1 – PBC Specialty Audits2 – overview of practice referral rates3 – Tips for Developing Practice Action Plans_1

4 – Alternative care pathways Version 3 15th November 2010

Information on additional topic areas where necessary e.g. Prescribing budget position/prediction Month 5 found here:Prescribing Budget predictions Sept 10For the most recent version contact
Reference – For your own reference, you may also want to include these on your visit What is It and how to use it

  1. A copy of the PBC Delivery scheme for 2010/11 – use if there are any queries on payment for the work outlined above including criteria for plans and level of payment for meeting targets
  2. Details of the Locality Board and contact names with lead areas
  3. Details of outpatient tariffs – use if there are any queries about high cost areas or particular queries on cost of outpatients
  4. Quality alerts – report on the quality alerts for 2009/10 – use to promote the use of quality alerts.  The links for reporting is on thsi website.
7 – 20100630_PBC incentive 1011_FINAL_Practice_versionContact locality leads as above9 – Outpatient tariffs 201011


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