TERMS OF REFERENCE
Engagement of Private General Practitioners for the Provision Of Service to Public Patients With Diabetes And Hypertension
BACKGROUND
As the number of COVID-19 cases continue to increase, the Ministry of Health and Wellness (MOHW) will be implementing a public-private partnership non-communicable disease shared care initiative. This initiative will seek to maintain essential primary care services for non-COVID-19 clients with diabetes (DM) and hypertension (HTN); enabling them to access routine care through private physicians and to free the resources of the health centres to focus on critical cases and the pandemic response.
The purpose of this initiative is:
- to minimize exposure of clients with chronic illnesses to COVID-19 at public health facilities;
- to maintain routine clinical management of non-COVID-19 clients with diabetes and/or hypertension in the context of scaled-down access to primary care services at public health centres during the COVID-19 outbreak in Jamaica;
- to identify and engage suitable private physicians in the selected areas to participate in a project for the medical management of public patients who are diabetic and hypertensive for a fixed fee to be paid by the NHF.
SCOPE OF WORK
The General Practitioner is expected to:
- manage referred diabetes and hypertension patients according to MOHW Clinical Guidelines;
- support the maintenance/attainment of control of their diabetes and/or hypertension;
- accommodate routine care visits over a six-month period (routine care visits are minimum three (3) months apart);
- collaborate with referring health centres to ensure optimal patient transition;
- identify specific day(s) each week to accommodate the referred patients.
ELIGIBILITY REQUIREMENTS
The Private General Practitioner must satisfy the following requirements:
- Full and up-to-date registration with the Medical Council of Jamaica (MCJ);
- Possess a valid Tax Registration Number (TRN);
- A valid Tax Compliance Certificate (TCC) or valid Tax Compliance Letter (TCL);
- Possess the requisite medical malpractice insurance or other relevant insurance coverage;
- Provide registration particulars for the support personnel/staff members within their practice, from a Regulatory body under the Ministry of Health and Wellness.
Qualifications
- Experience: The General Practitioner(s) must have a minimum of at least three (3) years’ experience in providing the services being proposed and the support personnel/staff members should have a minimum of at least two (2) years’ experience in providing care to Patients;
- Education: Additional Certification in Family Medicine, Cardiology, Endocrinology or Chronic Care Model training would be an asset;
In the case of General Practitioners operating as part of Medical Centres, they must meet the abovementioned requirements and qualifications individually.
If selected the following requirements shall be met:
Must be willing to accept a Service Fee of J$4,000.00 per patient visit;
Must have access to internet services;
Must be willing to receive payment weekly by electronic bank transfer;
Must have a comfortable waiting area compliant with the MOHW’s Infection Prevention and Control Recommendations for Employers: Interim Guidance for COVID-19 and for additional resources, visit: https://www.moh.gov.jm/covid-19-resources-and-protocols/
DELIVERABLES
Monthly reports as per MOHW prescribed templates.
SPECIFIC INPUTS FROM THE MOHW
- Training and ongoing Continuing Medical Education;
- Resource materials including but not limited to:
- DM and HTN clinical management guidelines (CMG);
- COVID-19 management protocol and other relevant protocols;
- Infection prevention and control protocol;
- Guidelines for diagnostic (laboratory, imaging) and pharmacy services;
- Referral protocol.
SPECIAL TERMS AND CONDITIONS
- Public sector employed physicians with dual practice privileges, must have written approval from their employer for private practice with defined hours of private practice;
- General Practitioners operating as part of Medical Centres must meet the required qualifications individually;
- Facilitate audits and assessments as prescribed by the MOHW;
- All resources and documentation produced from this partnership are owned by the MOHW and shall not be accessed, shared or published without the permission of the MOHW;
- Provide evidence of all practice address(es);
- Caribbean College of Family Physicians (CCFP) and/or Association of General Practitioners of Jamaica (AGPJ) membership is an asset.
PAYMENT SCHEDULE
Payments shall be made according to the following:
- General Practitioner will be paid J$4,000.00 per patient visit and no additional cost to patients;
- The General Practitioner will receive payments weekly via electronic bank transfers from the NHF;
- Provision of monthly reports on the health status of each patient that includes:
- The patients’ identification number/registration number/name;
- Services provided for each patient according the checklist supplied by the MOHW.
The General Practitioner shall maintain medical records, test results, and other documents that may be required by the MOHW as evidence of the Services provided. The MOHW may delay payments to the Service Provider if such documentation is not maintained and provided on request in order to validate payments.
DURATION
This project will be for two (2) years.
ADDITIONAL INFORMATION FOR APPLICANTS
The selected Private General Practitioners will be required to:
- Facilitate an initial assessment and ongoing assessments of the medical practice location as per the MOHW’s guidelines;
- Successfully complete prescribed trainings;
- Register with the National Health Fund (NHF);
- Adhere to MOHW DM and HTN clinical management guidelines in:
- Prescribing drugs (as per the MOHW’s Vital Essential and Necessary (VEN) Drugs and Medical Sundries for Public Health Institutions, 2020);
- Ordering scheduled investigations require imaging services (X-Ray and ECG);
- Providing in office HbA1C tests.
- Adhere to MOHW guidance Documents
- Referral Protocol;
- Release of Client Information Procedures Manual.
- Facilitate the provision of emergency services where required until the MOHW can respond.
- Prepare the requisite Medical Cause of Death Certificate where necessary.