Hot Topics April 2010
MID MERSEY LOCAL MEDICAL COMMITTEE
The Gables Cowley Hill Lane St Helens Merseyside WA10 2AP
• LOCAL ISSUES
• IT STRATEGY
Summary Care Records and EPS documents are currently under review with the LMC under the IT Sub Group.
Recently, due to intense lobbying from the GPC, the Government have suspended the accelerated Summary Care roll out. The BMA have expressed concern about the roll out taking place in areas where PIPs (Public Information Programmes) have not yet begun.
• PLCP (PROCEDURES OF LIMITED CLINICAL PRIORITY)
The LMC today discussed the merits and the processes for identifying procedures of limited clinical priority. It was felt that this would need further discussion. We will keep you abreast of proceedings or any changes.
• PREMISES DISPUTE PROTOCOL
We would like to bring to the attention of Practices in Warrington a document on the LMC website, www.mmlmc.org.uk, which gives in detail a protocol for local dispute resolution for determination of current market rent. The LMC believes this to be an excellent and comprehensive document and would help in future negotiations with the PCT. If you need any further information, please do not hesitate to contact Mrs Wick at the LMC office.
HALTON & ST HELENS
• ACUTE PSYCHIATRIC SERVICES
The LMC have recently undertaken a survey of Acute Psychiatric Services. To date, the LMC have received a good response to the survey. We would like to take this opportunity to remind colleagues in Halton & St Helens to help with the survey and we will hopefully have a clear idea of the needs and various concerns with Acute Psychiatric Services which we hope to address in a supportive and informative way with the PCT, who are broadly in agreement with the main principles that outline the survey.
NHS Halton & St Helens pay for a subscription for all GPs and Practice Nurses to access a travel medicine database called TRAVAX, which is excellent. Their website is http://www.travax.nhs.uk, user name homas81072, password 413-703.
• MEDICINES MANAGEMENT PRESCRIBING INCENTIVE SCHEME/QOF
This document was discussed and broadly agreed by the LMC and hopefully will soon be implemented in Knowsley.
• TRANSFORMING COMMUNITY SERVICES
The LMC has drawn up guidance for Transforming Community Services, copy of which can be accessed via the LMC Office or the LMC website, www.mmlmc.org.uk
• PRACTICES RISK HEFTY FINES FOR DATA BREACHES
GPs and Practices face hefty fines under new powers to curb personal data security breaches. A maximum of £500,000 can now be levied against Organisations guilty of serious breaches of the Data Protection Act. The Information Commission Officer (ICO) has been granted new powers by the Government which come into effect in April. The ICO can now hand down fines known as Civil Monetary Penalties in cases where data has been lost, either deliberately or negligently, and the breach is likely to cause damage or distress to the person involved.
• 2010/11 CONTRACT CHANGES
New Directed Enhanced Services Directions for 2010/11 and the associated SFE amendment are now available on the Department of Health website. These came into effect on 1 April 2010.
• EXTENDED HOURS ACCESS SCHEME DES 2010
The GPC and NHS Employers have agreed that the Extended Hours Access Scheme will continue for a further year from 1 April 2010. The main change from the existing arrangements will be that Practices will be required to indicate by 30 June 2010 whether they are proposing to participate in the new Extended Hours Access Scheme (or equivalent local arrangements) in 2010/11, so that PCTs are clear early in the financial year which Practices will be involved.
PCTs must, before 30 April 2010, offer all existing GMS and PMS contractors in their areas the opportunity to enter into arrangements for Extended Hours Access under the DES Directions. Contractors that wish to participate in these arrangements must submit a written proposal to the PCT within 28 days of the PCT’s offer to enter into arrangements under the DES Directions.
Where possible, PCTs must enter into these arrangements with Practices before 1 July 2010. PCTs will not normally be obligated to enter into Extended Hours Access arrangements after 30 June 2010 (exceptions are set out in the Directions). However, PCTs retain the discretion to do this if they wish.
Any agreement made under these DES Directions will last until 31 March 2011.
Once PCTs have established which practices will be involved in the scheme, they are expected to commission alternative arrangements for patients whose Practices are not involved in the DES or equivalent local arrangements. PCTs will be advised to use the balance of the funding available for extended opening to commission these services from:
• other GP practices already participating in this initiative
• GP health centres
• out-of-hours providers
• LOCUM GP PENSION CONTRIBUTIONS
The GPC is aware of anecdotal evidence of PCOs increasingly enforcing the rule whereby locum GPs engaged by GP Practices have a ‘10-week window’ in which to pension their income. Practices not paying locum GPs within this timeframe can lead to locum GPs missing this contribution deadline. This is a reminder of the importance of practices paying locum GPs for their work as quickly as possible, thus enabling them to pension their income.
• OVERSEAS DOCTORS
The GPC believes that Doctors who have not completed their vocational training in the UK should be required to demonstrate that they are suitable to work as unsupervised GPs in the UK. Suitability includes being fluent in English and an understanding of NHS general practice.
At present, the GMC is required to register any Doctor who meets the qualification requirements of being a GP; no further tests are used. We are working with the BMA's International Committee to ascertain whether the Medical Act can be amended to allow the GMC to require any further testing as may be required. PCOs, on the other hand, are able to require a Doctor to demonstrate that they have the relevant skills to work as a GP before granting entry to their Performers List. As a result, many PCOs require overseas Doctors to undertake language testing and/or a period of induction in order to have full list inclusion. However, at present there is no uniformity between PCOs, although this will hopefully be addressed through the current review of the Performers List Regulations that is currently underway.
In the meantime, we encourage all Practices to ensure that the Doctors they engage with are on a PCO Performers List, are on the GMC's GP Register, and that they are competent to undertake the work.
• BMA EMPLOYER ADVISORY SERVICE
The BMA Employer Advisory Service provides GP Partners with free comprehensive, impartial and authoritative advice on a range of employer-related matters. The service was designed to facilitate the BMA in representing both sides in a dispute between Salaried and Partner GPs.
Advisers will be able to deal with your queries on issues such as recruiting and employing staff, contracts and terms and conditions of service, appraisals and performance management, disciplinary procedures and dismissals. They are also well versed in current employment legislation, discrimination, the development of appropriate HR policies, and how to implement best practice. Advisers have excellent knowledge of local issues and well-established contacts with Local and Strategic Health Authorities, Primary Care Trusts and Local Medical Committees.
To access the service, at least one Partner needs to be a BMA member, although we would recommend all Doctors to be members of the BMA.
• IN-PRACTICE FELLOWSHIPS
Are you a GP with an academic interest? The National Institute for Health Research (NIHR) has recently launched in-practice fellowships which aim to offer academic training to fully qualified General Practitioners and General Dental Practitioners who may have already spent some time in NHS practice and who have had little formal academic training at this point in their careers. For further information visit the NIHR website.
• SUMMARY CARE RECORD (SCR)
The GPC today received an assurance from the Department of Health that the upload of the Summary Care Record in PCTs subject to accelerated roll-out will be suspended. The Department of Health informed the GPC that records will not be uploaded in PCTs subject to accelerated roll-out until there is greater public and professional awareness.
The Committee is very pleased that Connecting for Health has listened to its concerns and welcomes the decision to suspend uploads. We will be working with the Department of Health in future to ensure that GPC’s concerns about the Summary Care Record continue to be listened to and addressed.
• PRACTICE BOUNDARIES
Following the announcement by the Secretary of State last year that all boundaries would be removed from general practice, the Department of Health has now released a consultation on how this could be done. The GPC debated the proposals and passed a motion stating that:
‘GPC has carefully considered the current proposals for the removal of practice boundaries and has concluded that:
• they put the quality of patient care and patient safety at risk
• they will undermine continuity of care
• they will disrupt practice based commissioning
• they will increase NHS costs and introduce inefficient and ineffective
demands on resources
GPC therefore rejects the proposals.’
This position will be incorporated into the GPC’s response to the consultation. We will also put forward solutions which we consider to be preferable as detailed in the position paper we published in January.
• H1N1 VACCINES FOR TRAVEL USE
Professor Salisbury, Director of Immunisation at the Department of Health has sent a letter to all GPs informing of provision of the H1N1 swine flu vaccine for protection of travellers to Southern Hemisphere countries. Practices can use their existing stocks of H1N1 vaccine as a travel vaccine for members of the public intending to travel to the Southern Hemisphere during their influenza season. GPs are able to charge patients for administration of the vaccine and GPs can set their own rates for this service.
Note the paragraphs in the appendix which state that:
Whilst GPs can generally charge patients for administering an H1N1 vaccine in connection with travel abroad, if the contractor is participating in the Swine Flu Directed Enhanced Service or any Local Enhanced Service that provides for a payment in relation to an H1N1 vaccination, no charge can be made to:
• patients in the priority groups defined in the Swine Flu Directed Enhanced Service; or
• patients who are in a group covered by any local scheme under which the contractor is
paid for administering the H1N1 vaccine.
Patients in these groups should receive the vaccination free of charge in accordance with the Directed Enhanced Service or in accordance with the local agreement even if their request is related to travel abroad.
The letter can be found on the DH website at the following link:
• FIT FOR THE FUTURE
The GPC has published a 50-point plan for the future of general practice in the UK. Fit for the Future: The Evolution of General Practice sets out the Committee's current thinking on a number of policy areas, including out-of-hours care, quality and outcomes framework, workforce and IT. The full document and the executive summary, as well as a podcast from Laurence Buckman, can be accessed via the following link:
• NEW GP AND PHARMACY GUIDES PUBLISHED
NHS Employers, the General Practitioners Committee (GPC) and the Pharmaceutical Services Negotiating Committee (PSNC) have produced two guides to support GPs and Community Pharmacists in developing more effective working relationships.
The Guide to Pharmacy for GPs is designed to increase awareness of the work of Community Pharmacies and to encourage joint working. You may also find it beneficial in educating trainee GPs about community pharmacy. The second guide provides an overview on General Practice for Community Pharmacists.
The guides, on the work of Community Pharmacists and GPs, cover the following areas:
• the funding and contractual arrangements for Pharmacists and GPs
• the range of clinical and administrative functions that each profession
• various staff roles and responsibilities
• training and qualifications
• the key national bodies
• where to get more information on each profession.
The two guides are available on-line only at the following link, along with a letter to GPs (attached) from NHS Employers, the PSNC and GPC, introducing the guides:
• FIT NOTES
As of 6 April 2010, the Med 3 and Med 5 medical statements have been replaced with the new Statement of Fitness for Work. The DWP has produced a short guide on these changes, which can be accessed here:
Dr I A Camphor