GMS Contract, Agreements and Rates
Irish Medical Organisation

GMS Contract, Agreements and Rates

Under 6 Registration System

Patient Registration Process 

The online registration system will request the following information from patients:
• Details of the Child/Children, including name, address, date of birth and PPS number.
• Details of Parent/Guardian details, including name, address, phone number, PPS number and email address.
• Choice of GP – there will be a search function which the parent/guardian can search by GP name, Practice Name or Practice Address or town/region.
• Confirmation or refusal by parent/guardian in respect of Data Returns for periodic assessments and asthma cycle of care.

In terms of data protection issues, the parent/guardian will have the choice as to whether the HSE can collect clinical data in respect of their child and this will be established during the online process. The GP has no involvement in this and will continue to receive the enhanced payments whether or not the parent/guardian consents to data returns. In such circumstances the GP will have to submit that the periodic assessment and/or asthma checks have been completed but is not required to submit data and the system will not accept this clinical data.. The GP will be advised as to the patient choice in this regard.


As patients register and choose a GP the GP will be advised through the GP Suite of the names/addresses and contact details of those patients. The GP may then accept, reject or request that the patient contact the GP.


• If the GP chooses to accept the patient receives an email advising them that their GP of choice has accepted them and that a card will issue.
• If the GP chooses to reject the patient receives an email advising them to go back to the registration system and choose another doctor.
• If the GP requests that the patient contact the doctor the patient receives an email requesting that the make contact with the surgery.


For those GPs who are not using the GP Suite the patient will have to attend the surgery and the doctor will sign their form confirming acceptance onto the GP’s panel.

On an ongoing basis, as patients register, GP’s will be advised of patients being added to their panel in the same manner as is currently the case, and will also be able to check registration status online in the same fashion as they can currently review eligibility.

If you have any queries in relation to any of the above please do not hesitate to contact the GP contract helpdesk at 01 6767273, or by email to: gpissues@imo.ie.

IMO receives detailed legal clarifications on key concerns about Under 6 Contract

Monday 25th May 2015. The Irish Medical Organisation (IMO) has received assurances on a number of key issues relating to the proposed contract under which children under the age of six will receive free GP care.

Dr. Padraig McGarry, Chairman of the GP Committee of the IMO, also confirmed that the HSE has agreed that GPs have until 5th June to return contracts as the patient registration system goes live in early June. Additionally, it has been confirmed that there will be NO reassignment of existing under 6 GMS patients during the summer period.

Dr. McGarry said that the clarifications and assurances received from the HSE addressed many of the concerns that GP have raised in recent weeks; “we have listened very carefully to GPs across the country and when they have raised concerns, we have gone back to the HSE and sought clarification. I believe these clarifications will reassure GPs about key aspects of the contract.”

Dr. McGarry said that the IMO had sought legal advice on some of the issues raised and submitted that advice to the HSE for its review. The HSE has now written to the IMO to confirm that it agrees with the IMO’s legal advice and that the advice may be regarded as “contractually binding and may be relied upon by Under 6 contract holders and the IMO.”

Dr. McGarry said that the clarifications and assurances cover key areas raised by GPs in recent weeks. He said; “the concerns raised by GPs have been comprehensively dealt with through this clarification process. Whether the concerns were about fees, contract hours, implications for Data Protection or costs that might be incurred when hiring locums, the HSE has confirmed that our interpretation is correct. On all the contentious issues raised, the answers will reassure GPs.”


These reassurances include:

  • The HSE/Department of Health has confirmed that the Minister cannot set new fees for GP services without having regard to the Framework Agreement. The Framework Agreement sets down a process for negotiation between the IMO, Department of Health and HSE.
  • The HSE/Department of Health has confirmed that the new contract does NOT alter the status of GPs in respect of Data Protection. Specifically the HSE has agreed that the current position of GPs as Data Controllers (not Data Processors) is unchanged under the new contract.
  • The HSE/Department of Health has confirmed that the new contract does NOT introduce material changes to the practices governing the acceptance and transfer provisions regarding patients on the GMS scheme.
  • The HSE/Department of Health has confirmed that any new GMS contract will be a stand-alone contract negotiated between the HSE and the IMO and that the under 6 contract will not be a template for that new contract.
  • The HSE/Department of Health has confirmed that the Under 6 Contract is intended as an interim contract only and a review built in at the latest by 1st August next year.
  • The HSE/Department of Health confirms that Primary Care Teams are beyond the scope of this Under 6 Contract.
  • The HSE/Department of Health confirms that it will NOT impose any additional diagnostic services or pilot schemes without consultation with the IMO and agreement with individual GPs.
  • In the same vein, the HSE/Department of Health confirms that any new ICT initiatives (eg e-Health and management information initiatives) must be agreed with individual GPs prior to their introduction.
  • The HSE/Department of Health confirms that the working week provisions under the Under 6 Contract are the same as under the current GMS Contract.
  • The HSE/Department of Health has confirmed that GPs may carry out period assessments on child patients aged 2 and 5 opportunistically and not at the exact ages being reached.
  • The HSE/Department of Health has also confirmed the IMO’s advice in respect of issues including Termination and Suspension, Periodic Assessments and Out of Hours payments.
  • The HSE/Department of Health have confirmed that only those doctors who are on the Specialist Register can take up the Under 6 Contract

Under 6 Contract Clarification and Update

We understand the serious issues that are facing GPs in terms of the Under 6 Contract. We have been around the country and listened to the very real concerns of our members. GPs want to do what is right for their patients and their own practices and we have prepared a number of documents which we hope will address and clarify the important issues raised by GPs and set the record straight on what the contract clauses actually mean.

The decision you have to make as an individual has not been helped by the amount of misinformation and factual inaccuracies relating to certain aspects of the Contract. However it is important that whatever decision you are reaching you do so with the fullest possible information.

A document has been circulated to GPs in the past week which presents a view of the potential interpretation of certain aspects of the Contract however that document did not consider the supporting documents which support and ensure protection for GPs in terms of the contract provisions. It is critical that all documents are considered as all documents impact on the interpretation of the Contract provisions. I would like to state categorically that no new contract terms can be imposed without the parties engaging in negotiations under the Framework Agreement – the days of attempts at unilateral actions by the Department and HSE are over thanks to the High Court Settlement and Framework Agreement.

The IMO GP Committee, in order to ensure GPs have full information, have commissioned a legal view of the issues raised in published documentation and on foot of queries from our members. This can be seen here.

We also sought and received written confirmation from the HSE and the Department of Health that this is the correct interpretation of the contract and one on which GPs may rely. This can be seen here.

These documents clarify matters in relation to all 14 issues raised. For our part we have negotiated the contract in the best interests of GPs, and it is important to clarify any interpretation issues at this stage.

We would ask that you read these documents carefully and we hope that this brings a resolution to the fears of many of our members that the Under 6 Contract imposes new and unacceptable obligations on GPs.

We have made the HSE and the Department of Health aware of the many concerns of GPs, and in circumstances where GPs need more time to consider matters it has been agreed that the Patient Registration System will go live in early June – in effect this means that GPs who wish to be included on the database for selection as a GP will have to return contracts by 5th June.

The Department and the HSE are conscious of the need to have suitable transition arrangements to ensure that doctors who sign up now are not exposed to large scale assignments of existing Under 6 GMS patients from other practices where the GP has not yet signed. They have therefore confirmed to the IMO that they will not reassign any existing Under 6 GMS patients during the summer period. GPs who have not signed up to the contract will be paid for such patients on current GMS rates and not on the new rates applicable to the Under 6 contract.

The HSE have also confirmed that only doctors who are on the Specialist Register will be able to take up the Under 6 Contract. This applies to those GPs who are not existing GMS Contract holders.

Again, I wish to reiterate that the IMO, as a Trade Union with a negotiating licence, is there to work for the best interests of General Practice and individual GPs. We are absolutely committed to continuing with GP Contract negotiations so as to bring the necessary resources and capacity into General Practice and we make no apology for fighting for much needed resources in General Practice. We cannot let things continue as they are. The only people who suffer in that scenario are GPs themselves who are struggling to meet demand in an environment of reduced resources and lack of capacity but yet still continue to serve and meet the demands of patients.

We intend to work closely with our colleagues in the ICGP and have formally established a IMO/ICGP Contract Liaison Group. Our policy remains that any expansion of GP Care which is free at the point of access must be on a phased basis which allows General Practice to develop capacity. In our view the best way to expand GP Care is on the basis of income and the introduction of Chronic Disease Management.

We strongly urge you to read the attached documents so as to be fully informed. If you have any queries, concerns or wish to assess the financial impact on your practice please contact the IMO Contract Helpdesk on 01 6767273 or email gpissues@imo.ie.

We fully acknowledge that this is a difficult decision but we also must state that this deal is the best possible deal for GPs and allows to negotiate further agreements particularly with regard to chronic care. We must now continue with this work to allow general practice fully achieve its potential.

A certain acrimony has crept into the debate which I feel is unfortunate and which serves no purpose other than to blur the real issues – I would ask that you make your decision on the facts and nothing else.

We trust that this communication will bring clarity to these issues and thank members for their continued support as we work towards the viability of general practice.

Yours sincerely,
Dr Padraig McGarry
Chair, IMO GP Committee

GMS Agreements

GMS Capitation Rates

Capitation Payments

Capitation Payments

 Patient Category

Payment

Patients aged under 6 (including Supplementary out-of-hours fee)

€125

Enhanced capitation for Asthmatic Under 6 patients

Registration Fee

First year after registration

Each subsequent year

€50

€90

€45

Male patient aged 6 years or more and less than 16 years

€43.29

Female patient aged 6 years or more and less than 16 years

€43.79

Male patient aged 16 years or more and less than 45 years

€55.26

Female patient aged 16 years or more and less than 45 years

€90.37

Male patient aged 45 years or more and less than 65 years

€110.38

Female patient aged 45 years or more and less than 65 years

€121.29

Male patient aged 65 years or more and less than 70 years

€116.28

Female patient aged 65 years or more and less than 70 years

€129.72

Patient aged 70 years or more residing in the community

€271.62

Patient aged 70 years or more residing in a private nursing home (approved by the HSE) for continuous periods in excess of 5 weeks

€434.15

Supplementary out-of-hours fee

€3.64

Enhanced capitation for type 2 diabetic GMS patients registered on the cycle of care

Registration fee

Enhanced capitation

€30

€100

Special Items of Service

Payments to a GP in respect of special items of service

 Description

Payment

Excisions/cryotherapy/diathermy of skin lesions

€24.80

Suturing of cuts and lacerations — including application of tissue glue (does not include paper sutures)

€50.00

Draining of hydroceles

€24.80

Treatment and plugging of dental and nasal haemorrhages

€24.80

Cardiovascular investigations, solely for cases of individual patient care and not general screening or routine screening of individuals or both:

 (a) Electrocardiography (ECG) tests and interpretation;

 (b) 24 Hour Ambulatory Blood Pressure Monitoring for diagnosis and treatment of hypertension

€24.80

€60.00

Removal of adherent foreign bodies from the conjunctival surface of the eye

€24.80

Removal of lodged or impacted foreign bodies from the ear, nose and throat

€24.80

Nebuliser treatment in the case of acute asthmatic attack

€37.21

Bladder catheterization — composite fee for insertion and removal

€60.00

Long Acting Reversible Contraceptive Device (LARC) for counselling, insertion

€70.00

Removal of a Long Acting Reversible Contraceptive Device(LARC)

€50.00

Attendance by general practitioner at HSE-convened case conference

€62.02

GMS Leave

GMS Leave

Description

Payment

Annual leave (per day)

€197.24

Annual leave (per week)

€1,380.65

Sick leave (per day) during the first week

€197.24

Sick leave (per week) for the first week 

€986.18

Sick leave (per day) from week 2 to week 26

€197.24

Sick leave (per week) from week 2 to week 26 

€1,380.65

Sick leave (per day) from week 27 to week 52

€98.62

Sick leave (per week) from week 27 to week 52

€690.33

Study leave (per day)

€197.24

Study leave (per week)

 €1,380.65

Maternity leave (per day)

€197.24

Maternity leave (per week)

€1,380.65

Adoptive leave (per day)

€197.24

Adoptive leave (per week)

€1,380.65

Statutory leave — meetings of statutory bodies (per day)

€197.24

Attendance at Irish Medical Organisation GP Meetings (per day)

€197.24

Out of Hours Payments

Out of Hours Payments

Visitation  Type

Payments

Surgery consultation Monday to Friday (excluding public holidays) between the hours of 5 p.m. and 6 p.m. on the same day and 8 a.m. and 9 a.m on the same day 

€13.88

Surgery consultation Monday to Friday between the hours of 6p.m. and 8 a.m.  the following day and any time on Saturday Sunday and public holidays 

€41.63

Domiciliary visit out-of-hours

€41.63

Surgery consultation or domiciliary visit out-of-hours where a general practitioner sees an additional patient under the General Medical Services Scheme during the same consultation or visit

€13.88                                                

Practice Support Subsidies

Practice Support Subsidies

Description

Payment

Nursing subsidy (per year) 1 year’s experience

€30,945.86

Nursing subsidy (per year) 2 years’ experience

€32,665.07

Nursing subsidy (per year) 3 years’ experience

€34,384.29

Nursing subsidy (per year) 4 or more years’ experience

€37,822.72

Secretarial subsidy (per year) 1 year’s experience

€20,630.57

Secretarial subsidy (per year) 2 years’ experience

€22,349.80

Secretarial subsidy (per year) 3 or more years’ experience

€24,068.99

Practice manager subsidy (per year) — based on first point in the nursing subsidy

€30,945.86

 

GP SIs

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