Understanding PHPs, Health Action Plans and the DES

The Government have recently invested in health checks for people with learning disabilities. This means GPs are rewarded with a payment from the local Primary Care Trusts for doing the following:

  • Keeping an accurate register of people with learning disabilities by checking their GP practice list with the Local Authorities’ list of people receiving specialist learning disability services.
  • Attending training delivered by professionals from specialist learning disability services. This training must also involve people with learning disabilities.
  • Completing a comprehensive Annual Health Check for those who have a learning disability, registered with the practice.
  • Making sure that any health issues found are recorded in the patient’s personal health record forming the basis of a Health Action Plan.

Oxleas is supporting all GP practices in Bexley, Greenwich and Bromley to participate in this ‘Directed Enhanced Service’ (DES). A DES is the name given to directions from the Government for GPs to be rewarded for doing extra work to improve the health of their patients. It is an additional contract that GPs can choose to enter into. The basic contract for a GP is either a General Medical Services Contract (GMS) or a Personal Medical Services Contract (PMS). These contracts are quite broad and do not relate to specific work that some patients with complex conditions may require. As a result, the Department of Health provides extra funding for local services to complete additional work to meet the unique health needs of their local population.

In addition to the DES, GP practices can be rewarded for completing work as part of the ‘Quality Outcomes Framework’ or ‘QOF’. This framework rewards practices for work they do relating to certain conditions eg asthma, epilepsy, mental health, coronary heart disease etc. Points are rewarded for each health condition. Practices are rewarded with 4 QOF points for maintaining a learning disability register. Each point is rewarded with a payment.

How do these contracts relate to Personal Health Profiles and Health Action Plans?

As mentioned above, GPs are paid to ensure the health checks link in with their patients’ Personal Health Record and Health Action Plan.

A Personal Health Record belongs to the person being treated, not the health service. It has different sections to help record useful information about a persons health needs. Oxleas NHS Foundation Trust have supported some research into hand held personal health records and as a result, they produced Personal Health Profiles for everyone with learning disabilities who use their services.

The Personal Health Profile or PHP is designed to make sure that all of the facts about the owner's health are in one place where they are safe and can be found easily. However, the PHP is only as good as the information it contains and it is vital it is used routinely, and kept up-to-date, if it is to be effective. The Personal Health Profile page includes information to help explain the different parts of the PHP. 

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