- 10 Oct 2019
Attendees and apologies
- Neil Rennick, Chair
- Ruth Innes QC, Faculty of Advocates
- Ronald Renucci QC, Faculty of Advocates
- Ian Moir, Law Society of Scotland
- Paul Brown, Scottish Association of Law Centres
- Colin Lancaster, Scottish Legal Aid Board
- Raymond McMenamin, Scottish Legal Aid Board
- Gillian Fyfe, Citizens Advice Scotland
- Professor Graeme Roy, University of Strathclyde
- Professor Frank Stephen, University of Manchester
- Mark Thorley, Law Society of Scotland
- Ross Yuill, Society of Solicitor Advocates
Scottish Government officials
- Denise Swanson, Head of Access to Justice
- Kieran Burke, Bill Team Leader, Access to Justice
- Peter Conlong, Economic Advisor, Justice Analytical Services
- Neil Robertson, Senior Policy Officer, Primary Care Division
- David Notman, Head of Branch, Primary Care General Dental Services
- Jill Stephen Poller, Legal Aid Policy Officer, Access to Justice
Items and actions
Neil Rennick opened the meeting and welcomed the members to the panel.
The group was made aware that the website for the Legal Aid Payment Advisory Panel was now available at https://www.gov.scot/groups/legal-aid-advisory-panel/
Agenda item 1
Presentation on GP Funding by Neil Robertson, Senior Policy Officer, Primary Care Division, Scottish Government
The Scottish Workload Formula (SWF), applies to an agreed pot of existing funding streams which covers approximately 85% of GP funding.
The funding is divided up by practice patient list size with weightings for deprivation and old age. The list is based on geographical practice boundaries which can overlap with each other with list sizes varying from a few hundred to 43,000.
The remaining elements of general practice funding are Enhanced Services, Premises, Seniority Payments and Practice Income Guarantee.
The 2018 Scottish General Medical Services Contract is joint agreement between the Scottish Government and the British Medical Association (BMA). It came into force on 1 April 2018. The contract was negotiated against a backdrop of general practice facing unprecedented challenges: increased workload; increased risk relating to staff and premises; and recruitment and retention.
Prior to the 2018 GP contract, money was allocated to GP practices by way of the Scottish Allocation Formula (SAF). Under the SAF the single largest element of practice funding was the Global Sum which accounted for 64% of total practice payments. The SAF allocated, the Global Sum to practices on the basis of their patient list size. The allocation was weighted for factors that increase GP workload as measured by consultation rates – including the age/sex profile of patients and deprivation. It was also weighted to compensate for the presumed additional cost of delivering general practice in rural areas.
Agenda item 2
Presentation on NHS Dental Payment System by David Notman, Head of Branch, Primary Care and Dental Services, Scottish Government
The dental delivery model is similar to that of GP practices. The majority of General Dental Practitioners (GDPs) are non-salaried independent contractors. GDPs make arrangements with NHS Boards to provide NHS dental care and treatment. As independent contractors GDPs can provide a mixture of NHS and private treatments.
There are over 400 items of service each of which each of which has a set fee and are paid through item of service payments. Item of service fees are increased annually through the pay award. The pay award is made up of two components, a pay element and an expenses element. Each year the Doctors and Dentists Review Body (DDRB) make a recommendation on pay, net of expenses.
The General Dental Practice Allowance (GDPA) is to help with practice requirements for providing high quality premises, such as, health and safety and staffing costs. All practices can claim 6% of the accumulative gross earnings of the dentists in the practice providing all the dentists are included on a dental list, the practice has had a satisfactory practice inspection in the last three years and they have maintained or increased patient registration level. There is also a recruitment and retention allowance, remote areas allowance, seniority allowance and continuing professional development (CPD) allowance. In addition, there are maternity, paternity, adoption and sick leave payments plus commitment payments.
Priorities for next meeting
The group will take time to reflect on the specific questions that the two models and information from this meeting have raised.
It was agreed that information provided at the three legal aid payment advisory panel meetings to date should now be analysed by the group. The next meeting will move from the information gathering and awareness exercise into analysis and discussion.
Friday 4 September 2019.