Director of Primary Care Email Update to Practice Managers - March 2014
Sadly, our first item is a scam warning of the worst type. Patients all over the country are receiving e-mails stating that their recent blood test shows they have cancer. This is a scam and your patients should be reassured. Many of you will already be aware that NICE has posted a scam warning on its website.
BATH & NORTH EAST SOMERSET (BaNES)
Wessex LMC’s welcomes its new members from Bath and North East Somerset who have elected to be represented by Wessex LMC’s with effect from 1st April 2014. A number of PM’s have already started to attend our events and we hope to see many more over the coming years. Please do not hesitate to contact the LMC with any queries or just to share your experiences email@example.com
PRACTICE MANAGER REPRESENTATIVES ON LOCAL MEDICAL COMMITTEES
As you may be aware, 2 Practice Manager representatives sit on each of the three LMC Committees. The PM representatives hold office for two years and are currently:
- Hampshire & the Isle of Wight: Adrienne Ely (Southampton) and Jennie Dock (Southampton)
- Dorset, Bournemouth & Poole: Penny Gill (Kinson Road, Poole) and Karen Mills (Shaftesbury)
- Wiltshire &Swindon: Linda Thomas (Wiltshire) and Chris Gebel (Swindon)
The term of office for Adey, Penny and Linda ends on 31 March 2014, and we are therefore looking for nominations (or re-nominations) for those areas. Adey has confirmed that she does not wish to be nominated again and we wish her well in her new role.
Each LMC meets 6 times per annum (Hampshire and Isle of Wight and Wiltshire on a Wednesday afternoon and Dorset on a Thursday afternoon) and I am happy to provide further information to anyone who would like to express an interest in sitting on the relevant committee for which a small honorarium is paid. If you are interested please either phone or send an e-mail no later than 31 March 2014 to firstname.lastname@example.org.
In view of B&NES joining the Wiltshire Committee an additional PM representative has been sought and we look forward to welcoming Caron Tremaine-Tucker to her first meeting in May.
RETIRING PARTNER CHECKLIST
We are often asked by Practice Managers who they should notify when a Partner retires. This checklist provides a quick reference guide, covering some of the key things you need to consider.
Who to Notify:
- The Area Team
- The CCG
- The Superannuation Division
- The practice accountant
- The PCSE (Hampshire) or SBS (Dorset and Wiltshire)
- Medical Defence Organisation
- Patients over the age of 75 with their named GP as the retiring partner (still to be clarified)
- Shared Business Services (Dorset and Wiltshire), PCSE (Hammpshire) – ensure any forwarding address is included
Retirement can take one of the four following options:
- Retiring from the partnership and the Medical Performers List (MPL)
- Retiring from the partnership, not taking 24 hour retirement and staying on the MPL to do non partnership work
- Taking 24 hour retirement and returning to the partnership (still on the MPL)
- Retiring from the partnership, taking 24 retirement and returning to non - partnership work (still on the MPL)
Remaining on the Performers List?
If remaining on the performers list account needs to be taken of the following:
- If they wish to return to work in the NHS then they are limited to 16hrs per week for a month after that date (instead of the old 24hrs)
- They need agreement from partners on the terms return to the partnership (this can sometimes cause issues) e.g. hours worked, voting rights etc.
- The returning partner needs to make sure the agreement includes that they receive both elements of the superannuation payments on return (employees and employers)
- It is a contractual right under GMS
- The Area team should be consulted at the earliest opportunity and involved throughout
- They may, of course, wish to remain on the performers list in order to undertake locum work
For further information you can link to the relevant section of our website from here
For CQC there is a lengthy process to follow so complete the form for an outgoing partner as soon as possible: http://www.cqc.org.uk/organisations-we-regulate/gps-and-primary-medical-services/registering-cqc-information-gps-and-ot-21
If a new partner is joining the practice the process to add the new partner should also be started as soon as possible as this can take some time as s/he will need a DBS check counter signed by CQC which can take a while so worth getting ahead on it:
You cannot have failed to have heard by now that that the roll-out of care.data has been delayed by NHS England until Autumn 2014. Following pressure from the BMA, GPC, RCGP, Healthwatch and others, NHS England has agreed to review the communications campaign.
NHS England issued the following statement at the end of February:
"I am sure that you will have seen the media coverage about NHS plans to share patient information to improve healthcare outcomes. During recent weeks NHS England has heard concerns from patients, GPs and others. Having listened carefully to these concerns we accept that the public need more time to learn about information sharing, and we have now extended the Care.data public awareness campaign until the Autumn.
We will begin collecting data from GP surgeries in the Autumn, instead of the spring to allow more time to build understanding of the benefits of using the information, what safeguards are in place, and how people can object if they choose to;
We will work with patients and professional groups including the BMA, RCGP, Healthwatch and listen to GPs to develop additional practical steps to promote awareness with patients and the public, and ensure information is accessible and reaches all sections of the community, including people with disabilities;
We will look into further measures that could be taken to build public confidence, in particular steps relating to scrutiny of ways in which the information will be used to benefit NHS patients;
We will also work with a small number of GP practices to test the quality of the data. This will be voluntary.
We want to build public confidence in this programme so people fully understand the broad range of benefits throughout health and care services that information sharing can bring.
We will be providing regular updates but if you have any questions please contact us as follows:
Patients should call the dedicated patient information line on 0300 456 3531 the line is open Monday to Friday, 8am to 8pm and on Saturdays from 9am to 3pm. A text phone service is also available on 0208 7428620
GP practices can contact the HSCIC Contact Centre, who are acting as a helpline for GPs, by calling 0845 300 6016 or email email@example.com quoting ‘care.data GP’ in the subject line
General Care.Data enquiries email us at: firstname.lastname@example.org’
For a reminder of the opt-out codes for Care.data, click here.
Information for Patients and Opt Out Forms:
Click here for an example of a leaflet on data sharing, including an opt-out form that you may find useful to adapt for your own practice. Our thanks to the Arnewood Practice for this. (Practices in Dorset and Wiltshire can ignore the references to the Hampshire Health Record (HHR) which does only apply to Hampshire). Other examples can be found at the bottom of this page on our website
HSCIC BULLETIN FOR PRACTICES ON QOF 13/14
HSCIC has published an update on QOF for 2013/14. It includes some guidance on what practices should do when QOF is issued in March, as well as GPES and CQRS for 2013/14 QOF activity. It also confirms that NHS England is developing contingency plans to ensure practice payments are protected. GP Checklist for QOF 2013/14 Year End
The LMC is meeting regularly with both Area Teams and we’re seeking assurances from them that they do have contingency plans in place so that practices are paid on time. However, as a back-up we’re also recommending that practices take screenshots of their clinical systems on the 31st March.
The BMA has also produced some useful Guidance on QOF changes 2014-2015
Please note that if you have remaining vaccine stock, you can still vaccinate up until 31/03/14 and claim the DES payments.
We are advised that over the last 2-3 weeks there has been a substantial increase in local mortality and morbidity from confirmed cases of influenza (predominantly H1N1) and particularly in the 16-64yr age range.
In the south region there have been 47 ITU admissions and 8 deaths, the majority of which have been since January 2014.
LMC BUYING GROUP – JANSSEN VACCINES
The LMC Buying Groups Federation has been informed that Janssen will be ending production of all its vaccines later this year as their parent company Johnson & Johnson have decided to close down its main manufacturing plant in Bern, Switzerland.
Janssen is currently the Buying Group's approved supplier for travel vaccines and they had been appointed as one of four companies offering discounts on flu vaccines for the 2014/15 season. Janssen have assured us that any practice that had already ordered vaccines for next year's flu season will be allowed to cancel their order without any difficulty now that the decision to close their factory is going ahead.
As far as travel vaccines are concerned, Janssen can still supply Epaxal (Hep A), Vivotif (Typhoid) and Dukoral (Cholera) to Buying Group members at the negotiated discounts while stocks last, which is expected to be until at least the end of this year.
NHS REGULATIONS AMENDMENTS
The 2014 NHS Regulations amendments have been published and can be found at: http://www.legislation.gov.uk/uksi/2014/465/pdfs/uksi_20140465_en.pdf
The 2014 Premises Cost Directions include the necessity for practices with private landlords to agree a rental prior to the Area Team involving the DV in respect of the triennial rent reviews.
The GPC has spoken with a number of lawyers/solicitors about this rent review memorandum and have been advised that arrangements for these should be specified within the lease agreement. There are usually three types of clause:
- The landlord pays for the independent surveyors valuation
- The landlord and the tenant split the cost of the valuation, although this does not necessarily have to be 50 / 50
- The surveyor decides how much the landlord and the tenant will pay
Therefore, the GPC's position is that no GPs should have to cover the full fee for the surveyor, but it is of course dependent on the lease agreement. We hold a list of experienced primary care surveyors should you need one.
The GPC’s long-term aim is to try to restore confidence in the primary care premises market so that everyone can trust the District Valuers valuation. Unfortunately, the behaviour of private landlords and some surveyors has resulted in artificially high valuations. The Department of Health introduced the rent review memorandum as a way of reducing valuation appeals by GP tenants. DH alleges that landlords and surveyors have been deliberately driving up valuations in order to increase rental charges. This means GPs had to appeal low DV valuations in order to avoid being left with the liability for any short fall. Confidence was of course lost in the DV too, because it appeared that his / her valuations were too low (we suspect counter tactics here from the Department, but have no evidence).
NHS Property Services intends to pay for and manage the rent review memorandum process for its GP tenants, and it will be held up as an example to the rest of the primary care premises market in this respect. NHSPS aims to be an example in all other aspects of its role as landlord for NHS owned primary care estate, but it obviously has some work to do before it gets there! GPC is hoping that NHS Property Services is able to offer GPs much more affordable / attractive lease terms and arrangements, which will mean the private primary care premises market will have to fall in line, if it wants to remain competitive.
Thank you to all of those practices who have sent a copy of their CQC inspection report to the LMC. This is not only enabling us to check for any inappropriate issues which we then raise with the GPC e.g. all staff must have DBS checks, but is also showing the trend of outcomes inspected (all are covering staffing and recruitment).
As many of you will know, CQC will start to pilot their new approach to inspecting and monitoring NHS GP practices between April and October, at the same time as formal consultations on their provider handbook. The handbook will describe the new inspection process including detail on the key lines of enquiry they will be inspecting against from April. The consultation on the handbooks will launch in early April.
For more information go to:
To date nationally 8767 practices met all standards, 422 did not met all standards and 2 have had non-compliance enforcement action taken. Although we have received a few ‘did not meet all standards’ in Wessex (none of which were difficult to put right e.g. lack of vulnerable adult safeguarding policy) no practices received a non-compliance enforcement action, and the vast majority have been fully compliant.
PUBLIC HEALTH CONTRACTS
A number of practices have contacted the LMC regarding a clause within some of the Local Authority Public Health Contracts in respect of Medical Insurance and our thanks go to Judith Young, PM at Talbot Medical Centre, Bournemouth who contacted the Medical Protection Society and sent a copy of their response which is as follows:
‘As I am sure you are aware, the defence organisations to which the vast majority of GPs are members are not insurance companies, but mutual discretionary indemnity organisations. From an MPS point of view, membership entitles professionals to request assistance in the event of a negligence claim or other professional matter for the period that the individuals were in membership. There is no limit to the level of indemnity that may be paid on behalf of the member.
The request that you have received from the County Council, really needs an explanation of the indemnity situation of doctors and Practices to be explained to the Council at a high level. I would suggest that this is the responsibility of the CCGs or medical representative groups such as the Local Medical Committee.
My advice at this point therefore is to reassure the County Council that members of MPS have a sufficient level of “medical malpractice” cover, from the Medical Protection Society, but that you would advise the Council to liaise closely with the clinical commissioning groups for further information and explanations.’
The LMC is currently writing to all Public Health Departments on your behalf as outlined above.
PRACTICE MANAGER CONFERENCES
Thank you to all of those who attended the 2 PM Conferences held in February, and in particular for the very positive and helpful feedback. The presentations can now be found on our website at: http://www.wessexlmcs.com/article1032.html
Carole and Lisa
Directors of Primary Care
14 March 2014