The Original PHS contract ran 1st April to 30th September 2019, and has now been extended to run till March 31st?


Scheme Outline

Aims of the Scheme

  • Supporting Lewisham CCG deliver its QIPP plans
  • Improving clinical outcomes
  • Reducing unjustified variation in primary care across practices and within practices
  • Supporting ‘at scale’ collaborative working in primary care
  • Delivering proactive patient care in the community and closer to home
  • Reducing avoidable emergency activity (i.e. attendances and admissions)



The performance of practices will be ascertained and reported regularly through a dashboard produced by OHL (with input from Lewisham CCG). This dashboard will display performance against the indicators and positions of 1) Practices 2) neighbourhoods and 3) the borough. Appropriate EMIS searches will be available to GP practices to support monitoring and performance.

The performance will be discussed as an on-going agenda item on the CCG/OHL monthly meetings.


Areas of the scheme

  • Prescribing
  • Pathology
  • Referral Quality (outpatients)





Higher quality prescribing care is important in order to deliver care that is effective and in line with local guidelines. This scheme looks to support the following initiatives

  • Reducing the prescribing over the counter (OTC) medications
  • Increasing the utilisation of scriptswitch by GP practices
  • Reviewing the prescription of specific medications (low priority NHSE List)



Pathology Referrals

Appropriate use of pathology ordering is important to ensure tests ordered are appropriate and in line with best practice. In Lewisham work is currently being undertaken to simplify pathology ordering, unbundle particular tests and ensure that when tests are ordered it is in line with local guidance. This scheme looks to support:

  • The implementation of best practice for pathology ordering
  • The appropriate ordering of pathology tests
  • There are particular tests which form the focus for this area but it is intended that all pathology ordering is made more appropriate and not just these tests.




Referral Quality (outpatients)

This aspect of the scheme looks to support:

1. Spreading best practice protocols in primary care around referral quality for GP practices (including standardising practices around coding of referrals/ templates used following local guidance), and

2. Understanding and reducing where possible the variation in referrals to all secondary care specialities but with a special focus on the following top specialities.

The top specialities in Lewisham are as follows:

  • Cardiology
  • T&O
  • Dermatology
  • ENT
  • Gynaecology
  • Rheumatology
  • Ophthalmology