The prototypes were announced in 2015 and saw major changes in the way that the majority of remuneration is delivered. It is a blended system with a prototype practice’s contract value split between capitation and activity.
Two different types of prototype contracts have been introduced:
Type 1 – capitation will be used as the basis of remuneration for treatment currently in band 1 care, plus prevention, with activity payments being used for treatments currently in bands 2 and 3.
Type 2 – capitation will be used as the basis of remuneration for what is currently in band 1 and band 2 care, plus prevention, with activity payments being used for treatments currently in band 3.
The NASDAL meeting heard that there had been widespread support for the concept of a move away from an activity based contract towards a prevention approach, but that there were a number of ‘teething issues.’ Martin commented, “Everyone is committed to the philosophy but there have been some initial problems highlighted by the prototypes. Some are having difficulty in keeping patient numbers at a level that works. There are 83 prototypes and we at the BDA have always felt there should be more. If and when the prototypes are rolled out, there would need to be geographic weighting on the capitation element across the UK. However, rollout is some way off.”