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LMC Email update June 2015

Date sent: Sunday 28 June 2015

Email sent by Wessex LMCs, on  28th Jun 2015

Whilst recognising the major challenges we face in general practice,  we are now seeing positive changes that will help and support general practice.

These changes will start to come through the New Models of Care but we need much more.  

Last week we were presented with the Secretary of State's new deal for general practice.  Hopefully you will have received and read the LMC's response to this. If not please click here. There are a number of things that will add to the potential for improving general practice but most recuire new and recurrent funding.

This email update should provide you with lots of information about both national and local issues.


1. PMS reviews

2. Wessex LEaD - Award received from the Royal College of Nursing (RCN) Foundation.

3. Lunch and Learn Training Resource – Chaperone Training

4. Practice Manager Appraisal

5. Practice Nurse Revalidation

6. SMS Text messaging

7. New and amended meningococcal vaccination programmes for 2015-16

8. Examinations and sickness certificates 

9. GP practice annual complaints data (KO41b return) 

10. Removal of patients from GP lists

11. Overseas visitors and primary care

12. Focus on rent reimbursements for leasehold and owner-occupied GP premises 

13. Updated PGD and PSD guidance 

14. Business rules – enhanced services 

15. Sessional GP e-newsletter


 1. PMS reviews 

As part of the programme of moving to equitable funding the Area Team and CCGs will be reviewing all PMS budgets and moving practices towards a baseline funding that is similar to GMS practices by 2021.

All PMS practices should have been contacted by the end of July and provided with financial schedules and it will therefore become clearer what each practice is facing in terms of funding.

If you are a PMS contract holder please read the attached.


 2. Wessex LEaD - Award received from the Royal College of Nursing (RCN) Foundation.

Louise Greenwood was delighted to accept an award at the recent Royal College of Nursing Congress Awards Ceremony at Bournemouth International Centre which launched the 2015 RCN Congress. The Wessex RCN Fund for Practice Nurse Advancement award was:

“in recognition of impact achieved through learning and development to improve patient experience and nursing care”

Louise successfully applied for bursaries through the foundation which contributed towards the GPN Refresher programme run by Wessex LMCs’ Local Education and Development ( LEaD) office which enabled practice nurses across Wessex to attend excellent updates in key treatment areas at an accessible price.

More bursaries are available to nurses in practices, so please do visit their website to see if there are monies available to support any of your nurses individually in their education and development


 3. Lunch and Learn Training Resource – Chaperone Training

This series of resources encourages the practice to learn as a team whenever it suits you. Lunch and Learn Resources are bought at £30 and can be used as part of induction and as part of whole team learning and can be run as many times as you like.

Chaperone Training guides all those who act as chaperones in the practice on what the role entails and raises awareness of the importance of the role -  an area in which CQC has taken a particular interest. For more information and to purchase the resource please click here

 Feedback from two PMs in May about the Lunch and Learn Training Resources

“These are just brilliant. Did the safeguarding one during a TARGET afternoon – very good training and made you stop and think. The case studies were very informative. I will be doing the Dementia one shortly”

"I’ve run the Emergencies in General Practice session for all staff 3 times in the last month with great discussion and feedback each time. The staff have found it really valuable to have a cross-team discussion, the admin staff have raised concerns about things like interrupting doctors, use of the panic button, and calling ambulances (and indeed on Tuesday we had one of the scenarios actually happen, and the receptionist involved were able to put practice into reality with a great result).


 4. Practice Manager Appraisal

Our Practice Manager Supporters are specially trained to not only support PMs, but also to undertake their appraisals.

The Supporters are paid by the LMC for up to 2 sessions per month to support new PMs with what their role entails and with current PMs with anything that might concern them.

Recent assistance has been given with HR, stress, Friends and Family test, Care Plans, TPP and recruitment.

Do encourage your PM to contact them with any issue that they would like to chat through: 

The PM Supporters will travel anywhere in Wessex – you do not have to pick the one located nearest to your practice.

Practice Managers appreciate and value the opportunity to be appraised by a peer, just as GPs do. Therefore, we have trained our PM Supporters to be able to appraise PMs. There has been excellent feedback for this including this:

“ I really cannot thank my appraiser enough – I feel much clearer about how I plan to meet my learning and developmental objectives”

Please speak to Louise Greenwood or visit our webpage  for more information



 5. Practice Nurse Revalidation

The start date for revalidation for all nurses  has been pushed back to 1st April 2016.

Practice Nurses will need to:

*If you go to the NMC website there are templates for the nurses to complete

Now, nurses need to:

Start to look at the information that is on the NMC website ( ) to familiarise themselves with the above.
Check that the NMC have their correct postal address and email address.
Check their revalidation date to see if they will be first to be revalidated.

The LMC has produced two new Lunch and Learn training resources for nurse revalidation:

1.  This one is for Hants, IOW and Dorset as the LMC worked with their CCG nurse leads and they were keen for some specific info to be included ( eg they want the practices to let them know the names of the confirmers, reflectors).

Nurse revalidation information for Dorset, Hampshire and IoW Practices and nurses.

2. This one is for general use

Nurse revalidation information.


 6. SMS Text messaging

As you may be aware, central funding for the provision of SMS services for practices was withdrawn by the Department of Health in March 2015. The decision was taken in order to reduce the overall cost of the service through local control and accountability, with responsibility devolved to CCGs. NHS England subsequently decided to fund the SMS service for primary care until 30 September 2015, to allow a replacement service to be procured. A replacement SMS service has now been established through the provider EE.

NHS England is writing to CCGs this week, asking them to confirm their plans for the continuation of SMS services for practices. They have been asked to confirm the practices they represent, as well as the SMS service the CCG intends to provide. CCGs will have a choice of using the replacement service provided by EE (as the default), or to procure their own alternative service.

The letter also asks CCGs to ensure patients and practices experience no interruption in their NHS SMS provision, and that practices should be able to exercise individual choice in their provider, with the EE service available to all, even where other practices within the CCG choose an alternative.

The letter to CCGs, a briefing on the transition arrangements, and some FAQs are available on the following page (see underneath ‘SMS messaging transition arrangements’):

Click here for further information.



 7. New and amended meningococcal vaccination programmes for 2015-16

 Meningococcal B (Men B) for infants

An enhanced service to deliver Meningococcal B vaccination has been agreed. The programme is for three doses of vaccine at 2, 4 and 12 to 13 months. This programme will commence on 1 September 2015 and will run to 31 March 2016. There will be a payment of £7.64 per dose plus £2.12 (to recognise additional workload) with a total fee of £9.76 per dose.


 Meningococcal ACWY (MenACWY)

Due to a rapid increase in meningococcal group W (MenW) disease in England, JCVI recommended an emergency programme to vaccinate all 14-18 years-olds (school years 10-13) with a quadrivalent MenACWY conjugate vaccine.  This new programme will commence on 1 August 2015, and is a single-dose programme for all patients aged 18 years on 31 August 2015.   There will be a payment of £7.64 per dose plus £2.12 (to recognise additional workload) with a total fee of £9.76 per dose.


 Mengingitis C vaccination for University freshers

The Men C University freshers programme, which was due to start on 1 April 2015, has been on hold until the MenACWY vaccine becomes available. The MenACWY vaccination programme will now commence on 1 August 2015, which is when the MenC vaccination programme for freshers will also commence.

The Men C booster will be offered to freshers (first time university or further education students who have received notification via UCAS to obtain MenC vaccination – aged 17-25) not previously vaccinated with MenC since reaching age 10 who self-present at their practice for vaccination. There is a flat fee of £7.64 for one dose.

Further information about all these programmes is available in the attached table and on the BMA website Vaccs and Imms pages. The service specifications are available on the NHS England website.


 8. Examinations and sickness certificates 

It should be noted that GPs are not required to provide sick notes for schoolchildren.

When children are absent from school owing to illness, schools may request a letter from a parent or guardian, and this is no different during an exam period. However, children who have missed exams due to illness are frequently told by schools that a note from a doctor is required; but there is no requirement for this to be provided by a GP.

Aside from the fact that parents/guardians are responsible for excusing their children from school, GPs cannot provide retrospective sickness certification. When a child suffers from a long-term condition, any certification will be provided by the responsible specialist.

The GPC has sought and received confirmation from the Office of the Qualifications and Examinations Regulator that Awarding Organisations make no requirement for pupils to obtain a medical certificate in support of their application for special consideration.

Students are asked for information in support of their application, but this may take the form of a statement by the school.

The Joint Council for Qualifications has confirmed that as far as they are concerned, if a student was absent from an examination as a result of illness and has the support of the school or centre to be absent, special consideration will be granted on that basis.

Awarding organisations do not insist that medical proof is provided.

There will be greater pressure on schools from September as their targets for school attendance will increase once again. They will be looking to reduce avoidable absence both in terms of fines for parents who take their children on holiday during school term time and for those will genuine or not so genuine health issues.

 A solution that is worth considering

In my practice area we had lots of requests from parents and schools for certification for absence, notes to excuse PE etc - rather than just say no, we met with the local Head teachers (they weren't as scary as I once remember them, in fact they were quite human!) and we discussed our various issues.

We agreed to work with them and immediately stopped all the trivial requests. We introduced a much more structured system to help and support children who needed to be off school and the system has reduced the  avoidable health absences. Some 4 years later the scheme is still running and my practice of 13,500 has only had 2 children on the scheme in that time.

click here for more details.


 9. GP practice annual complaints data (KO41b return) 

NHS England has written to GP practices asking them to submit data on written complaints received by the practice between 1 April 2014 and 31 March 2015.

This is an NHS-wide data collection and asks practices to submit numbers of written complaints made by patients (or others acting on their behalf) about GP services. The figures to be submitted are total numbers of complaints by service area and subject of complaint, and the number of these that were upheld. No personal confidential data is included in this collection. The questions are unchanged from previous years’ collections, but will now be collected through the Primary Care Web Tool.

NHS England has stated this is a statutory requirement under The Local Authority Social Services and NHS Complaints (England) Regulations 2009. There is a contractual requirement under the GMS regs (Schedule 6, Part 6, para 92) to comply with the requirements of the 2009 complaints regulations. Practices are therefore advised to complete the return. The deadline for submission is Wednesday 8 July 2015.

The letter sent out to practices, and guidance on completion, are available below:

1. Introduction letter

2.  Guidance


 10. Removal of patients from GP lists

Updated guidance has been published on the BMA website  covering the situation where a violent patient needs to be removed from the practice list. In particular it emphasises the responsibility of the practice to ensure a violent patient is removed in accordance with the provisions introduced in 1994 allowing the immediate removal of any patient who has committed an act of violence or caused a doctor to fear for his or her safety, so as to reduce their liability for any further acts of violence committed by the individual on other NHS premises.


 11. Overseas visitors and primary care

Updated guidance on overseas visitors and primary care is available on the BMA website. This covers the key areas of pre-existing conditions (can be treated ), registration discretion, treating as a TR, discrimination,  requesting formal identification and providing private care.   

This now incorporates updated guidance published by the Department of Health and available online.


 12. Focus on rent reimbursements for leasehold and owner-occupied GP premises 

This guidance gives an Explanation of the different types of ‘rent’ reimbursements for GP premises: notional rent (for GP owner-occupiers), borrow costs reimbursement (for GP mortgage holders) and leasehold rent reimbursement (for GPs in rented premises) plus other FAQs about premises costs. This guidance is available on the BMA website.


 13. Updated PGD and PSD guidance 

The GPC’s guidance on Patient Group Directions (PGD) and Patient Specific Directions (PSD) in General Practice has been updated following regulatory and organisational changes within the NHS, and new NICE Guidelines.

The guidance is available on the Drugs and Prescribing page on the BMA website.


 14. Business rules – enhanced services 

The first batch of Enhanced Service Business Rules for 2015/16 have now been published on the HSCIC website at the below link:

Enhanced Services business rules v 5.0 - Health & Social Care Information Centre - click here

This includes Dementia, Learning Disabilities, Rotavirus and Pneumococcal with others to follow as and when completed and timeframes agreed.


 15. Sessional GP e-newsletter

The June edition of the sessional GP e-newsletter was sent out yesterday and is available online - click here

This edition focuses on Sessional GPs and the recent LMC Conference. It also features news and information aimed at supporting sessional GPs as well as blogs from sessional GPs, including one from Dr Mark Selman on supervising GP trainees in OOH.


Best wishes


Dr Nigel Watson

Chief Executive

Wessex LMCs

Churchill House, 122-124 Hursley Rd

Chandler's Ford, Eastleigh

Hants. SO53 1JB (Registered Office)

Tel: 02380253874

Mobile: 07825173326



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Updated on 30 June 2015 1962 views