Bulletin 84

14.12.10

GPC & PHMC Joint Statement Public Health White Paper

The GPC and BMA Public Health Medicine Committee have published this guidance document on how both groups of clinicians can most effectively work together in the commissioning environment proposed in the NHS White Paper.

Bulletin 83

07.12.10

Tees Commissioning Event 2 (18 Nov) Scribe Notes

You can view the notes from each locality breakout group by following the links below. These notes are as recorded at the event to aid practices and have been kindly collated and provided by the PCT. The LMC will also be discussing these notes and considering next steps.

Hartlepool Notes
Middlesbrough Notes
Redcar & Cleveland Notes
Stockton Notes

Public Health White Paper

The White Paper on Public Health has been released along with a consultation document. You can view both documents here.

Practice Registered Patients List Cleansing

As you will be aware, a list cleansing exercise was recently undertaken across Tees by the NEFHSA. However, last month the Department of Health wrote to all SHAs asking them to work with PCTs, who in turn will work with LMCs, to carry out patient list cleansing exercises but to ensure that the process is sensitive to the many requirements being placed on practices at this time, and that due recognition is placed on the many demands on individuals’ time and expertise. PCTs have also been asked to make sure that they recognise the most vulnerable in this process: that those without a fixed address or with communication issues arising from language or literacy needs are not disadvantaged in the list cleaning processes.

GPC Sessional GPs White Paper Guidance

The GPC has published a new guidance document in its series on the NHS White Paper. The guidance outlines to sessional GPs the changes proposed in the NHS White Paper, explains how and why they could become involved in these changes, and discusses other potential impacts on the working lives of sessional GPs. The document is available here.

'Difficult to Obtain' Medicines List

All doctors should be aware that The Pharmaceutical Services Negotiating Committee publishes a list of medicines that pharmacies have reported having problems obtaining. This list is regularly updated and is available here.

Warning, Debt Collectors and Patients Confidentiality

We have been made aware of concerns (elsewhere in the country) that debt collectors have been contacting practices, pretending to be healthcare professionals, in order to get personally identifiable information about patients. If you have any requests of this kind or are suspicious of a request please notify the LMC.

Bulletin 82

23.11.10

Tees Commissioning Event (18 Nov) Presentations

You can view the presentations from the latest Tees Commissioning event by following the links below and we will circulate the feedback notes from each group as soon as they are in a readable format.

PCT Functions - presented by Celia Weldon

Finance, current position - presented by Audrey Pickstock

Many thanks to all who attended and made this another successful event on GP Commissioning on Tees. We hope that you found the event useful, feedback on the day was positive though it was suggested that we need to head towards locality meetings next time round and look again at the attendee list. If you do have any feedback on the event or any suggestions/comments for future events please do not hesitate to email them to janice.foster@middlesbroughpct.nhs.uk. The events we plan are for you and we want them to be of maximum benefit to you - to do this we need your views.

LMC Board Meeting November Minutes

The minutes for the November Board meeting are now available here.

GPC Sessional GPs Subcommittee Election Results

The results of the election to the GPC Sessional GPs Subcommittee for 2010-2013 have now been announced and the full list of members is available here. Congratulations to Rachel McMahon and Paula Wright who are your elected representatives for the North East. The subcommittee will hold its first meeting on 2 December.

Bulletin 81

16.11.10

GPC Guidance Documents - structure of GP-led commissioning and developing a shadow consortia

The GPC have produced two important guidance documents - they provide advice on the form and structure of GP-led commissioning consortia and developing a shadow consortia. 'The Form and Structure of GP-Led Commissioning Consortia' identifies a range of considerations regarding the discussions that will need to had locally, the relationships will need to built and the decisions that will need to made as this agenda moves forward. 'Shadow Consortia: Developing and Electing a Transitional Leadership' outlines a number of options that will need to be considered when developing the transitional leadership structures that will take shadow consortia forward. It also gives guidance on how to appoint the transitional leadership, giving information about elections, and selection / election processes. It would be beneficial for you to view these documents ahead of the GP Commissioning event on the 18 Nov to help inform discussions and focus your thoughts.

Two New White Paper Consultations Open for Comment

Both consultations close 14 January. Have your say!

'An Information Revolution' is about transforming the way information is accessed, collected, analysed and used by the NHS and adult social care services so that people are at the heart of health and adult social care services. 'Greater Choice and Control' explains in more detail the proposals which envisage a presumption of greater choice and control over care and treatment, choice of treatment and healthcare provider becoming the reality in the vast majority of NHS-funded services by no later than 2013/14 and seeks the views of patients, the wider public, healthcare professionals and the NHS.

LMC Guidance re Confidentiality and Security Policy Compliance - Cancer Screening Programmes

Practices will have received a request from the PCT with regard to completing confidentiality and security policy compliance paperwork linked to the Cancer Screening Programmes. The LMC believes that this is an unreasonable request given the governance/confidentiality procedures and policies that are already in place and adhered to. We consider practices may decline to complete the paperwork if they feel they wish to. We have taken this request to the GPC in order that it may be pursued at a national level as, it is understood, that this is the consequence of a request made nationally in the first instance. If you have any questions regard this, please do not hesitate to contact janice.foster@middlesbroughpct.nhs.uk.

Bulletin 80

08.11.10

NICE Guidance in General Practice

NICE have launched a new website to keep primary care professionals up to date with NICE guidance. It gives access to guidance during a consultation, steps to ensure a practice is up to date with clinical guidance and support for commissioners. NICE are accepting feedback on the site until 1 December. Further information available here.

Revalidation: The Way Ahead

The General Medical Council has published this response to their consultation on proposals for medical revalidation in the UK.

Bulletin 79

01.11.10

CQC Registration Reminder

We would like to remind NHS GP practices that they do not yet need to comply with Care Quality Commission standards. The registration window for CQC will open from October 2011 and NHS GP practices will need to be registered from 1 April 2012. Monitoring of compliance with the CQC standards will not commence until 1 April 2012. However, it is worth noting that PCTMS practices should be registered with CQC because PCTs needed to be registered from 1 April 2010. Also organisations that provide some NHS primary medical services but whose main purpose is to provide other services, such as private healthcare, social care or NHS acute services need to have been registered for all of their services from 1 October 2010.

The GPC in tend to publish ‘CQC for GPs’ guidance in the first quarter of 2011. This will explain registration and provide advice on compliance with the CQC standards with the aim of reducing the burden and bureaucracy for practices.

NHS Appraisal Toolkit Update

As you are aware, the DH contract for the provision of the NHS Appraisal Toolkit expired at the end of this October . The DH have written this letter to PCTs & SHAs regarding arrangements following the expiry of the contract. For your ease the MS Word version of the appraisal forms referred to in the letter are here. Locally, you should have received an email (which was sent out to all GPs) a little while ago, advising you that a return to a ‘manual’ system was anticipated. GPs should use an electronic template, not unlike the current Toolkit template, which can be emailed between appraisers/PCT appraisal team, with supporting information being presented ‘manually’ to appraisers. There has been discussion at a regional level over the adoption of a uniform template for appraisal, which Dr Lone has seen and commented on.

White Paper, BMA Resources and GPC Guidance

The BMA has developed a number of resources available to members to support further engagement on NHS White Paper proposals. This introductory letter from Hamish Meldrum contains all the links to access the resources. The series of guidance notes, produced by the GPC, to advise and inform practices and LMCs as to what the new proposals may mean for them, and what they should think about as they consider how they would be implemented are available here.

QoF, Achievement Data 09/10 and Indicator Diabetes 23

The QOF achievement data for 2009/10 was published this week. A summary of the results and full spreadsheets can be found here. Following on from an article published by GP Notebook on 30 September titled ‘Targeting Type 2 diabetes’, NHS Employers and the GPC would like to clarify that there have been no changes to the HbA1c targets for diabetes in 2010/2011. NICE published their menu of recommended changes on 3 August 2010 which included a recommendation to increase to the HbA1c target for DM23 from 7, as it is currently, to 7.5. In line with the new QOF process, this menu of recommendations is now subject to agreement through formal negotiations between NHS Employers and GPC on changes to QOF across the UK. Once negotiations have concluded, any changes to the QOF will be published by NHSE and the BMA and the QOF guidance will be updated and published on the relevant websites ahead of the new QOF year.

Delegation of GPC Powers to Sessional GPs Subcommittee

The GPC has changed its standing orders and formally agreed to delegate power to act on matters that relate wholly or primarily to sessional GPs to the GPC Sessional GPs Subcommittee. The delegation of powers will take effect from the subcommittee's first meeting of the session, on Thursday 2 December.

SCR

The SCR review is now complete and guidance from NHS Connecting for Health (CfH) has been sent to PCTs/SHAs. Currently, the main implications from the review are to GP practices that have created SCRs containing more than the core clinical information of medication, allergies and adverse reactions. As we understand, practices in Tees have only included core clinical information but if you have any concerns please contact the LMC or PCT. Further guidance will follow from NHS Connecting for Health for the practices concerned. In addition, constructive discussions are taking place around the practicalities of implementing the SCR Review recommendations and further communications/guidance will follow in due course. Until this guidance is forthcoming, we would advise practices to continue dialogue with PCTs but practices should not feel pressured to create SCRs.

Bulletin 78

19.10.10

Tax Relief on Pensions, update on changes

Following the publication in July of the discussion document entitled "Restriction of pensions tax relief: a discussion document on the alternative approach", the Government has now announced the changes that will take place for restricting pensions tax relief. The main points are:

1. Annual Allowance reduced from £255,000 to £50,000 from April 2011.
2. Lifetime allowance (LTA) reduced from £1.8 million to £1.5 million from April 2012.
3. Deemed contributions to defined benefit schemes calculated using a simple "flat factor" method set at 16.
4. Proposal that unused allowance from up to three previous years will be carried forward to offset against the excess contribution.

Bulletin 77

12.10.10

Patients with Dental Problems

Patients with dental problems requesting a GP appointment because they have been unable to procure a dentist to treat them, seem to be on the increase. Doctors do not treat dental problems, however, treatment can be given for the pain. Having contacted all the PCTs, should a patient attend your surgery, apparently unable to find a dentist to treat them, please give them the contact number shown below:

To find the nearest dental practice taking on NHS patients in the Tees area, visit www.tees.nhs.uk or call the dental helpline on 0345 045 0620, or Text: 07700 380000.

If you need a dentist in an emergency, call 0845 603 3131. You will be given the next available emergency appointment at a dentist somewhere in Teesside.

You may wish to use this poster.

Hep B for Employment /University Related Matters

Unfortunately NHS regulations prohibit a GP practice in contract with the PCT from providing occupational health related Hep B vaccine on a private basis when funded by the patient. You may wish to provide your patients with a version of this template letter the LMC has developed. You will also wish to ensure a proper risk assessment has been carried out in such circumstances, and the LMC’s current advice is that this should normally be provided by an occupational health service provided by the person’s employer. Hep B must, of course, be provided when this is part of a treatment programme for an individual following an incident such as a human bite.

Performers List Responsibilities

There are a number of commitments doctors entered into when joining the Performers List. These include keeping the NEFHSA informed of home addresses and where you are working; informing the PCT of any criminal charges, convictions or cautions but not fixed penalty notices; informing it of any investigation of your conduct by the GMC any other professional body or another employer. Please ensure you notify Sue McGann at NEFHSA, 01325 553 071 or NEFHSA, The Old Exchange, Barnard Street, Darlington, DL3 7DR, of any change to your contact details. This is particularly important for locum GPs who may working in a number of practices.

MDO

Ensure your GMC/MDO subscriptions are up to date and that the organisations know your current address. Inadvertent slippages are often avoided by having Direct Debits rather than waiting for a reminder. GPs may wish to review subscriptions periodically and ascertain from their MDO, the services available to them in case of need to ensure it still provides appropriate and satisfactory services to meet their requirements.

Requests for Letters and Certification

Policy set out by the Cabinet Office in 2002 addressed reducing the unnecessary red tape and bureaucratic burdens placed on GPs such as reducing the levels of paperwork GPs have to contend with to ensure as much time as possible is used for patient care. This includes removing the need to provide certification of sickness when a student misses exams, certification for short-term sickness for employers and various letters from public bodies to confirm residency etc. There may be some instances when it is appropriate to respond to these requests e.g. clinical or child protection issues, but the majority can be politely refused. Please seek advice fro the LMC if you are unsure as to whether refusal is appropriate

Bulletin 76

05.10.10

9th Sept LMC/PCT Event - Summary of Facilitated Groups Feedback

We have now collated all the feedback gathered at the event. Thank you once again for engaging fully on the day, there were a lot of comments to work through. The LMC has tried to reflect the general feelings expressed and draw conclusions on taking commissioning forward on a single page for each question. The LMC summary can be viewed here. The PCT have provided a full copy of the information captured on the flip charts here.

If you would like to arrange a meeting with Janice to discuss any elements of the event or GP commissioning going forward please do not hesitate to call 01642 737 627 or email janice.foster@middlesbroughpct.nhs.uk.

NHS White Paper, BMA Response to Consultation

The BMA has published its response to the NHS White Paper ‘Equity and Excellence: Liberating the NHS’. This response sets out the BMA’s position on the key themes and overall direction of travel for the NHS described in the White Paper, as well as views on specific reforms and initiatives. A briefing page can be viewed on the BMA website and all of the associated documents and BMA responses can be found on the website here or by following the links below:

• White Paper summary response
• White Paper full response
• Commissioning for Patients Consultation summary response
• Commissioning for Patients Consultation full response
• Regulating Healthcare Providers Consultation summary response
• Regulating Healthcare Providers Consultation full response
• Transparency in Outcomes Consultation summary response
• Transparency in Outcomes Consultation full response
• Increasing Local Democratic Legitimacy in Health Consultation summary response
• Increasing Local Democratic Legitimacy in Health Consultation full response

Bulletin 75

28.09.10

9th Sept LMC/PCT Commissioning Event Papers

We are planning a follow up event mid November so please keep an eye on the diary dates. Below are links to all the http://www.mysurgerywebsite.co.uk/website/IGP367/files/supporting information to support the 9th Sept event. We hope to share a full summary of feedback from the facilitated groups next week but a brief overview of the outcomes shows:

• GP consortia should be developed through PBC arrangements, ensuring that the right balance is struck between 'local ownership and efficiency'
• Clear desire to work together across 'Tees' within key principles with clear milestones being established at an early stage
• Transition from PCT to GP consortia needs to be managed
• Clinical commissioning starts now
• Interim arrangements for PCTs should include explicit support for GP Commissioning
• Central to success will be effective 'relationship management'
• Real concerns about losing key competencies and starting 23012/13 without a deficit

• LMC Presentation
• PCT Presentation Points
• Facilitated Workshop Questions
• LMC (very) brief summary of the White Paper
• BMA Positioning Statement
• NHS Confederation Reaction
• PBC Summary North Tees
• PBC Summary South Tees
• PCT Proposed Structures
• PCT Statutory functions
• PCT Strategy Health Outcomes
• Tees Informatics Summary

• undertakes the LD DES;
• has been part of a practice merger since 1st April 2010, and who has not, when the merger took place, previously agreed a health check learning disabilities register in respect of all the patients of the new practice.

Bulletin 74

21.09.10

NHS General Practice Workforce Census

We would encourage practices to participate, particularly this year , as it is important that accurate and complete information is available to inform the discussions on the implementation of the NHS White Paper and particularly GP led commissioning.The NHS Information Centre will be distributing templates to PCTs shortly and PCTs will then contact practices to ask for this information.

The GPC generally supports this annual census as a means of getting accurate information negotiators on both sides, to support negotiations in the coming year. This census (as at 30 September each year) is one of three which together deliver statistics on the total NHS workforce. The other two censuses relate to hospital and community health service staff in medical, and non-medical, roles. General practice workforce statistics in England are compiled from data supplied by or on behalf of around 8,200 GP practices. The NHS Information Centre for health and social care liaises with these organisations and their agents to encourage complete data submission, and to minimise inaccuracies and the effect of missing and invalid data. The general practice census aims to gather information on all practices and practice staff in England, including GPs. It delivers a detailed view of the workforce including staff type, headcount, full-time equivalence, age, gender, and country of qualification (in the case of GPs). It also delivers information on practice size (in terms of number of GPs, and list size). It has historically been published at the level of SHA and PCT. You can view recent census publications online.. The collection of information is rigorously vetted and controlled by the Review of Central Returns process which demands ministerial approval for any collection and specifically seeks to reduce the burden imposed on the service.

The majority of the information for the census is obtained automatically from the Connecting for Health / NHAIS / 'Exeter' GP practice re-imbursement system, the aim being to reduce the burden imposed on practices. The census has a number of uses, including workforce planning; planning and development of education and training; evidence to Doctors’ and Dentists’ Review Body (DDRB); policy development; monitoring changes in general practice provision (eg by contract type); parliamentary accountability (eg. in answering parliamentary questions); public accountability under the Statistics and Registration Act.

Occupational Health Advice Lines

The Department of Work and Pensions has set up two new types of occupational health advice line for GPs and small businesses in England, Scotland and Wales. One provides guidance to GPs on health and work issues affecting individual patients. The other provides support to small businesses on all occupational health issues, including those raised by the new Statement of Fitness for Work. Both services are staffed by qualified occupational health nurses. The two types of advice line have different contact numbers. The phone number for the occupational health advice line for GPs in England is 0800 022 4233 and the phone numbersfor the occupational health advice line for small businesses in England is 0800 077 8844. Further information available here.

Family Health Service Appeal Unit New Address

The Family Health Services Appeal Unit, responsible for determining contractual disputes between GPs and their PCT, now has a new address and contact details. These are:
1 Trevelyan Square
Boar Lane
Leeds
LS1 6AE

Telephone: 0113 86 65500
Fax: 0207 821 0029
DX: 26416 Leeds Park Square

BMA 2011 Research Grants

The 2011 research grants will be available to apply for online here from mid-December this year. The application deadline is 11 March 2011.

The BMA was among the first of the professional bodies to award grants and prizes to encourage and further medical research. Today, around 12 research grants are administered under the auspices of the Board of Science, all funded by past bequests to the BMA. Grants totalling approximately £500,000 are awarded annually. Applications are invited from medical practitioners and/or research scientists and are for either research in progress or prospective research. Subject specifications for each grant vary. For example, in 2011, research areas range from rheumatism and arthritis, cardiovascular disease and cancer to asthma, social determinants of health and neurological disorders. A leaflet providing more information on the grants on offer in 2011 is available here. If you have any questions about the BMA research grants, or would like to receive alerts about them, please contact Evelyn Simpson at info.sciencegrants@bma.org.uk or telephone 020 7383 6755.

Bulletin 73

1. the clinical benefits are insufficient to justify continuation at present, particularly at a time when patients are being denied proven clinical services on the grounds of expense;
2. the clinical benefits are insufficient to justify the creation without fully informed explicit consent;
3. the clinical benefits are insufficient to justify GPs consenting to the upload of data on behalf of patients who have not expressed consent;
4. the creation of SCRs in England should be halted until the full review of the model, and other models, has taken place to address cost-effectiveness and the need for informed and explicit consent of patients.

Bulletin 66

13.07.10

Tees Confidential Deaths Inquiry Process

Just a quick note to reassure practices that the inquiry to address the high suicide rates in Tees as mentioned in Bulletin 63 (22/6/10) will not lead to duplicate work for practices. You will be aware that there is an on-going request (coordinated by Denise Colmer) made to GPs to complete an audit proforma each time a death by suicide or undetermined injury is identified. This work will continue but the PCT are aware how busy practices are so they will select the cases that are to be examined in more detail through the new Inquiry Process and will ensure practices only receive the relevant form to complete - be it the new form or the existing form you are familiar with. In short, you only need to complete one form and the relevant form will be sent to you.

QoF Business Rules

Version 17 of the QOF business rules have been published here.

QMAS 09/10 Achievement Calculation - sexual health

This note from Connecting for Health addresses errors in the calculation of QMAS sexual health indicators.

Sessional GPs Newsletter

The Sessional GPs Newsletter, Summer 2010 covers a number of topics including GPC Sessional GPs Representation Working Group report, Salaried GPs’ Pay, BMA Salaried GPs’ handbook - 2010 edition, Revalidation and Locum GP pensions .

Kings Fund Inquiry into Quality of General Practice

As the initial results become available the King’s Fund is very keen to gather the personal views of the profession on the research they have commissioned, so that they are able to frame their ideas for the final report. Details of the reports that have been published to date are below; the King’s Fund would welcome your comments and feedback. There is an on-line resource page here:

Continuity of care
Diagnosis and referral
End of Life care
Therapeutic relationships

Bulletin 65

06.07.10

SCR Update following BMA ARM

Following the publication of the UCL evaluation and the ARM debate about SCR, the GPC position is that Public Information Campaign (PIP) and uploads should be suspended. GPC do not believe that practices should feel pressurised by PCTs into participating in uploads to SCR. GPC have written to the Minister requesting a moratorium and await his reply.

Eligibility for QoF PE7 & 8 Easements

By July 30, the ImmForm programme team had archived the swine flu vaccination data from October 09 to February 10 to free up storage space on the ImmForm system. This means that the vaccination data for this period will no longer be accessible to practices (although it will remain available to the PCT). The March data, which will still be available, is cumulative so includes the uptake figures from October - February. The March data will remain accessible until the end of October 2010 at which point the data will only be accessible via PCTs and SHAs.

In the event that a practice is disputing their figures, a copy of the extraction reports could be useful, and as such the practices should save a copy of the report on their internal system to ensure they can access it in the future if necessary. This letter has been sent from the DH to SHAs/PCTs to outline this.

Bulletin 64

29.06.10

SCR Tees Drop-in Sessions

NHS Tees are running a number of drop in sessions for patients to help enable them to become more informed with regard to the Summary Care Record. The meeting dates and information can be viewed here. If you would like further details on SCR or would like to arrange a meeting/consultation/drop-in session for your practice please contact ruth.atkinson@middlesbroughpct.nhs.uk who will be able to help.

Breast Cancer Care Research Project

Breast Cancer Care is looking for GPs to help shape one of its services for people who have come to the end of active treatment for breast cancer. This press release contains further details, including how to get involved.

DH Spending Challenge Consultation

A major public engagement exercise was announced today to help shape the forthcoming Spending Review. NHS staff are hugely involved in this process and the Prime Minister, David Cameron is asking for them to share their ideas on how we can rethink public services to deliver more for less. An engagement programme is being run from 24 June to 9 July to collect ideas on how the Government can deliver services more efficiently while maintaining and improving quality. This website has been specifically set up to gather up these ideas, with every serious idea being considered by government departments, the Treasury and by teams at No 10 and the Cabinet Office.

GP Trainee GPC Elections

Nominations are now open for regional representatives to the GPC GP Trainees subcommittee. Please tell any GP trainees you know to visit www.bma.org.uk/gptraineeselections to find out more about the election process and what being a member of the subcommittee involves. Even if they are not considering standing for election, they should visit the site to make sure they are registered to vote

Bulletin 63

22.06.10

Focus on New Tax Brackets

The “Focus on new tax brackets” guidance has been revised and a spreadsheet added which illustrates the financial implications of taking on a salaried GP. Please also note the addition of the Mazars LLP letter report and the General Practitioners Defence Fund Limited (GPDF) disclaimer, both of which are integral to a proper understanding of this guidance and of its accompanying schedules, which are presented for illustrative purposes only. Note that this guidance may have to be revised again after the emergency budget has been announced on 22 June.

Patient Survey and Calculating Eligibility for QOF PE7 & PE8

Full details of the Patient Survey results can be found here. PCTs will now use the patient access data in the survey for calculating practice payments under the QOF. As part of the H1N1 vaccination DES, those practices that meet the minimum target for vaccinations will receive a 10 per cent drop in the upper - and 20 per cent in the lower - thresholds in PE7 and PE8. Practices should be aware that the ImmForm Swine Flu data extraction programme, which has been used to assess uptake levels for the QOF easements, calculates the denominator on the age of the eligible patient population at the date of extraction, rather than the age of the patients at the time of vaccination. This is likely to have a minor impact on the number of patients in the six months age range because those who were previously not eligible, will now appear as eligible. This is not expected to be a large number and will mainly impact on those practices that are close to the 50.7 per cent target. Practices who do not believe that the figures are an accurate reflection of their eligible patient population can, with the agreement of their PCT, perform a manual calculation to work out if they have qualified for the patient experience easements. Practices can use the data extraction report as a template to perform this calculation. An example of the report and details of the formula to be used, are available in annex 4, page 15 of the H1N1 vaccination DES guidance, available here.

Tees Suicide Prevention & Confidential Death (Suicide) Inquiry

In order to address the high suicide rates in Tees (some of the highest in the country) the PCTs have appointed David Robinson in a new role of Confidential Deaths Inquiry Coordinator (Suicide). David will carry out confidential inquiries into suicide and undetermined deaths for the Tees wide area and be the single point of contact for you on this area to aid a coordinated approach to improving this terrible issue in Tees. We urge practices to work with David as there will be real benefit for everyone in understanding these deaths better. The purpose is not to repeat an inquest but to understand more so interventions can be put in place to help prevent it from happening again. You can follow the links below to a number of PCT documents providing background on this and you will find a sample questionnaire here. We appreciate that the questionnaire does appear long but can reassure that we are talking very small numbers and not all sections need to be completed so it should not be too onerous. David will be contacting Practice Managers shortly to provide further details and discuss resources to support practices with this. He will then work with Practice Managers on an individual basis when a specific case comes up as some practices may (hopefully) never have a case that touches on this.

• Suicide inquiry introductory letter from Peter Kelly (PCT)
• Summary of work re suicide prevention
• Draft protocol suicide inquiry

Bulletin 62

15.06.10

Distribution of Pay Uplift Across GMS

We are sure you will have seen the details around the distribution of the gross 0.8% uplift for 2010/11 across GMS but for clarity it is outlined below. The methodology recommended by the DDRB will be used to distribute the 0.8%. Application of this methodology translates into an uplift of 0.41 per cent for the Quality and Outcomes Framework (QOF) and 0.41 per cent uplift to enhanced services and locum payments. The weighted price per patient will increase from £63.21 in 2009/10 to £64.59 in 2010/11. In England, payments inclusive of these uplifts will be made to practices from 1st July and backdated to 1st April 2010.

• half of 0.8 per cent will be applied to the following five elements of the GMS contract, in proportion to their current relative spend: global sum; correction factor; Quality and Outcomes Framework; enhanced services; and locum payments;
• the remaining half will be invested in the global sum, with no corresponding increase to correction factor payments;
• any money that is released through reductions in correction factor payments will be reinvested back into the global sum, reducing the number of practices on the Minimum Practice Income Guarantee (MPIG).

Bulletin 61

08.06.10

European Medical Directory Scam

WARNING - it's here again! We have had reports, locally and nationally, that there is another round of circulars from the European Medical Directory/Med1web/Novachannel scam. What ever it is calling itself this time round it is the same wolf in sheep's clothing. DO NOT SIGN ANYTHING! It will cost you!

Employment Contract Reflecting ISA Registration

As of November 2010 it is mandatory for all new clinical staff (GPs, HCA, Nurses) employed by practices, directly or through an agency e.g. locums, phlebotomists, to have ISA registration to comply with the vetting and barring scheme. In preparation for this we would suggest practices may like to consult their professional advisors to ensure that there is a clause written into all employment contracts to cover ISA registration. This should extend to contracts/agreements covering the use of agency provision to ensure staff through this route also comply. Amending contracts can take some time due to the staff consultation requirements so it is advisable to think about the implications and start the process now. Further details on the vetting and barring scheme and ISA registration can be found here and in this useful FAQ.

NICE Topic Selection Panels

The National Institute for Health and Clinical Excellence seeks new professional members for its Topic Selection consideration panels. This panel invitation letter from NICE provides more details.

BMA/GPC Sessional GP Report

The GPC's Sessional GPs Representation Working Group, set up to review the representation of sessional GPs at a national and local level, has published its report which can be viewed here. To inform its work, the working group also commissioned an extensive research exercise, taking in the views of sessional GPs, LMCs and other external organisations. The report recommends a number of reforms to the way in which sessional GPs are represented within the GPC. These are as follows:

• Delegating authority to the Sessional GPs Subcommittee of the GPC so that sessional GP representatives act on matters wholly or primarily relating to sessional GPs.
• Doubling the size of the subcommittee to 16 members.
• The formation of a sessional GPs executive committee, which will meet regularly and with the GPC’s negotiating team when necessary.
• Four permanent seats on the GPC for members of the sessional GPs subcommittee, in addition to the sessional GPs already elected via regional and national elections.

Bulletin 60

01.06.10

Striking a Balance, GPC Consultation

The GPC "Striking a balance" consultation asks how, especially in the context of the current economic climate and increasing demand for services, General Practice can be protected, developed and strengthened in line with patient, public and GP priorities. Please forward this consultation to your patient participation groups. The consultation website is www.strikingabalance.org.uk and a pdf copy of the consultation can be downloaded from here.

CQC Registration - prevention and control of healthcare associated infections

CQC registration will apply for NHS GPs from April 2012. However, in some areas (though we have not been alerted to this in Tees) PCTs are telling practices that, because of CQC, they must fully comply now with the Health and Social Care Act 2008: Code of Practice for the NHS on the prevention and control of healthcare associated infections. There is an ongoing consultation on how the Code of Practice will relate to primary care but at the moment it is guidance only and it is not yet necessary to fully comply.

Pension Contributions

In 2007, the GPC agreed that for the year 2008/09 there would be a one off arrangement between the Department of Health and BMA that GP tiered contributions would be based on their 2006/07 pensionable pay as declared on their annual end of year 2006/07 certificate regardless of what they actually earned in 2008/09. Further details on this tiered contribution system are available here.

NICE Skin Cancer Update

Please note that the NICE skin cancer guidance update has now been published. Cancer service guidance – skin tumours including melanoma (2006) & Skin cancer partial update (2010) documents can be viewed here.

Bulletin 59

25.05.10

Notification of Infectious Diseases

Under the Public Health (Control of Diseases) Act 1984 (as amended), GPs are required to notify the proper officer of the local authority when they have reasonable grounds for suspecting that a patient:

• has a notifiable disease as listed in Schedule 1 of the Act;
• has an infection (not listed in Schedule 1) which, in the view of the GP presents, or could present, a significant harm to human health; or
• is contaminated in a manner which, in the view of the GP, presents or could present significant harm to human health.

Bulletin 58

18.05.10

Medical Notes for Students Missing Examinations

The GMC has recently written to Ofqual informing them that GPs are not required to write letters in support of special consideration applications for students taking examinations. Ofqual has informed all examination centres of this and JCQ regulations for 2010/2011 will be amended to reflect it. Medical notes should not be required as a matter of routine but the circumstance in which students might ask their GP to provide confirmation of illness and further details are available here.

Bulletin 57

11.05.10

SCR Statements (update)

Statements have been released by the BMA and DH (to SHA) to update all involved on the current stance with regard to SCR. They can be viewed here: joint BMA/NHSE statement, statement/letter to SHAs

GP Patient Survey Update

This update aims to explain the results process for the 2009/10 GP Patient Survey, directing practices to sources of information and helping to prepare for the release of final survey data for this year.

Learning Disabilities DES Guidance

The DH has published guidance on the LD DES which is available to download here. Following the introduction of the LD DES, the GPC requested that NHSE and the DH provide further guidance on the DES to assist with implementation. Unfortunately, although the guidance answers some of the concerns, many outstanding issues remain. The DH guidance has failed to address concerns about the ambiguity in interpretation of the DES, the scope for room for unacceptable local variations in its implementation and the resulting potential for disagreements between GPs and PCTs to arise. GPC has written to Anne Williams, National Director for Learning Difficulties at the DH to raise these issues.

Bulletin 56

04.05.10

H1N1 Vaccination Agreement Q&A Update

The joint GPC / NHSE document, "Question and answers – the swine flu (H1N1) vaccination agreement", has now been updated and includes guidance on calculating the vaccinations uptake for the purpose of receiving patient survey threshold easements. It is available here.

Bulletin 55

27.04.10

Revalidation Consultation

1 March the GMC launched a consultation on its proposals for how revalidation will work in practice and on 31 March launched a consultation toolkit to help local groups of doctors have their say on GMC plans. The toolkit, which is web-based, can be found at here; where you can find out more information about the consultation and download a consultation document. If you have a question about the toolkit, please email thewayahead@gmc-uk.org. The GMC hope you find the toolkit helpful and look forward to receiving your views on their proposals. They do want to hear from as many doctors as possible as the feedback they receive as part of this consultation will help further develop plans for revalidation.

H1N1 for Travel

A reminder that GPs can generally charge patients for administering an H1N1 vaccine in connection with travel abroad and there is no funding available through the PCT for H1N1 purely for travel purposes -unless the patients are:

• 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;

Bulletin 54

20.04.10

Summary Care Records (SCR)

The GPC has 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. The GPC 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. Press release.

Bulletin 53

13.04.10

H1N1 Flu Line

Please can you ensure all posters and material which direct patients to the dedicated Swine Flu website/phone line are removed from your practice as this is no longer in operation and is confusing for patients. Apologies if you have completed this already but the SHA want to ensure this has taken place.

General Practice and Community Pharmacy Guides

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. This covering letter introduces the guides which are available on-line only and can be accessed here.

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 provides
• various staff roles and responsibilities
• training and qualifications
• the key national bodies
• where to get more information on each profession

• The NHS Board of the Year – new for 2010
• The NHS Community Leader of the Year – new for 2010
• The NHS Innovator of the Year
• The NHS award for Inspiration
• The NHS Leader of the Year
• The NHS Mentor of the Year
• The NHS Newcomer of the Year – new for 2010
• The NHS Partnership Award of the Year
• The NHS Quality Champion of the Year

Bulletin 52

30.03.10

GPC Annual Report

This year's GPC Annual Report is available to view here.

NICE Consultation, New QOF Indicators

NICE have launched a consultation on thirteen possible new indicators including mental health, diabetes and palliative care in QOF and are seeking views on implementation challenges, possible unintended consequences and impact on health inequalities. The deadline for comments is 11 April 2010. Comments received during the consultation will be considered by the independent Primary Care QOF Advisory Committee in June along with the results of the pilot which saw the testing of potential new indicators across a representative sample of general practices. NICE will then publish a menu of recommended 2011/12 indicators in August which will feed into negotiations between the GPC, the Department of Health and NHS Employers. You can view and respond to the consultation here.

Bulletin 51

24.03.10

Extended Hours DES 2010 and DES Directions 2010/11

As previously reported, 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.

Extended access to GP services remains a priority of the English government. The DH has made it clear that PCTs should try to maximise the number of practices offering extended hours access and is keen that PCTs commission additional appointment times in line with patient preferences as expressed through the GP patient survey. 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 or out-of-hours providers.

There is obviously a risk in this policy of further fragmentation of routine patient care, especially as information sharing between practices is far from straightforward. The reality is that consultations taking place outside a patient’s normal practice may be limited for practical reasons to treatment of minor illness.

The new Directed Enhanced Services Directions for 2010/11 are available here along with the associated SFE amendment; coming into effect 1 April 2010.

Practice Boundaries Survey

The Department of Health has released a public consultation on its proposal to remove boundaries from general practice. We would encourage practices and individuals to submit a response, online here. The GPC set out its views on practice boundaries in this position paper in January and will submit a response based on the ideas it contains.

H1N1 Vaccination for travel use

Practices should have received this letter informing of provision of the H1N1 swine flu vaccine for protection of travelers to Southern Hemisphere countries from Professor Salisbury, Director of Immunisation at DH. Practices can use their existing stocks of H1N1vaccine 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.

Bulletin 50

16.03.10

DDRB Report letter

We are sure you will have seen the recommendations for 2010/11 published by the DDRB last week and the subsequent government decision to overrule some elements. This GPC letter to GPs is in response to these recommendations.

SCR, message re opt-out and GPC Guidance

It is important for practices to raise patient awareness of SCR, including the patients' rights to opt out. You should provide balanced, unbiased information to empower patients to make an informed decision. Please note: if patients use the envelopes in their patient information packs to return their opt out form it will be destroyed. This may result in patients thinking they have opted out when in fact they haven't. You may wish to have a supply of the opt out forms and promote the correct address for patients to return the form in your practice as this information is otherwise only available via internet/telephone.

The address for Tees patients to return forms is:
Summary Care Records
Healthcare Technology Commissioning
Teesdale House
Westpoint Road
Thornaby
Stockton on Tees
TS17 6BL

This guidance represents the GPC's views and may be helpful in answering any questions you may have.

Withdraw: Focus on Tax Bracket information

The Focus on Tax Bracket information published last week as been withdrawn and should not be used. GPC advisers have confirmed that there is an error in the figures and other matters in the guidance also need to be reviewed. This information has been removed from our website and it is hoped a corrected version will be issued as soon as possible. Please accept our apologies for this and any difficulty it may cause.

BMA Charities Letter

This letter contains details of 2 charitable funds that could be of benefit to you or a doctor you know.

Bulletin 49

09.03.10

Future of GP Practice Premises, updated document

This updated guidance examines the current state and future of the various primary care premises development options available and describes the premises provisions of the GMS contract. It incorporates GPC guidance on the premises costs directions and on the impact of the Disability Discrimination Act.

CQC Quick Guide to Registration

The Care Quality Commission is introducing a new registration system for all NHS Trusts, independent healthcare providers and adult social care providers. The new system comes in gradually from April 2010. This guidance provides a quick guide to registration.

GP Earnings and Expenses 2007/8, final report

The GP Earnings and Expenses 2007/08 Final Report has been published. The Provisional Report for 2007/08 was published in September 2009. This Final Report for 2007/08 contains additional information on earnings and expenses by practice size, Strategic Health Authority and rurality.

Salaried GP Handbook (BMA members only)

The 2010 version of the salaried GP handbook is published 8 March and is free to all BMA members on request via e-mail, support@bma.org.uk or telephone 0300 123 123. Salaried GP BMA members should receive a copy automatically by 22 March, if you have not received your copy by this date use the above details to make your request. The Handbook explains the legal entitlements of all salaried GPs as employees. It therefore helps to ensure that salaried GPs are aware of their statutory and contractual rights, and helps to prevent GP employers unwittingly falling foul of the law. It also contains sections on other topics such as how to become a salaried GP and the work involved.

This 2010 version of the Handbook has been updated to take account of changes in employment law and other areas, as well as clarifying guidance from the previous handbook. It includes new sections on maternity leave and redundancy, and updated information on many other areas such as salary, hours of work, sick leave and employment protection. The 2010 handbook is also be available to members here.

Bulletin 48

02.03.10

Summary Care Records (SCR)

There are serious concerns about the implementation of the SCR across the country. The BMA/GPC continue to press CfH for more resources to publicise and to assist practices with the work involved and have produced this guidance to assist practices. Londonwide LMCs are kindly sharing some useful information they have produced which is available here and for your ease the opt-out information and form (which is hidden at the end of the document!) is here.

Fit Notes

From 6 April 2010 the current Med 3 and Med 5 medical statements are being replaced with the new Statement of Fitness for Work. The DWP have produced a short guide on these changes here.

Pandemic Flu - ready reckoner (PE7 & PE8 easements)

NHS Employers have sent this letter to all PCTs with details of a ready reckoner that has been produced to calculate the easements to the thresholds for QOF indicators PE7 and 8 as part of agreement for the phase 1 swine flu vaccinations.

Impact of 2009 Budget on NHS Pensions

In his Budget on 22 April 2009, the Chancellor announced the introduction, from 6 April 2010, of a new additional rate of income tax of 50%, applying to taxable income over £150,000. In order to prevent this resulting in an increase to the tax relief granted on pension contributions, the Chancellor also announced that from 6 April 2011, tax relief on pension contributions for high earners will be restricted. The BMA has produced guidance that looks at the changes to tax relief on pension contributions, along with the ’anti-forestalling’ measures that the Government has put in place to limit individuals who may otherwise have been tempted to maximise their tax relief by making additional contributions before 6 April 2011.

GP Academic Fellowships

Are you a GP with an academic interest? The National Institute for Health Research 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. Further information here.

Bulletin 47

23.02.10

Interim Guidance on Erroneous Transfer

This interim guidance has been developed by the GP2GP project and the Joint GP IT Committee to advise practices how to reduce the risk of making an erroneous record transfer request and advising practices and PCTs how to manage such erroneous requests when they do occur.

Pandemic Flu - vaccination programme

Letters regarding the H1N1 vaccination programme have been sent out from the Department of Health advising practices to continue vaccinating at risk groups opportunistically beyond the end of March. For this they will continue to receive payment, though not the related DES concessions. Practices will be advised to stop vaccinating children under 5 from the end of March. The Joint Committee on Vaccination and Immunisation has suggested that the vaccine can now be offered as a travel vaccine for those travelling to Southern Hemisphere countries during their flu season. This is likely to be provided through private travel health providers. The letters are available here.

2010/11 Certificate of estimated pensionable income

The Estimates of NHS Pensionable Profits/Pay form for 2010/11 can be found here. Every practice must in law complete this before April 2010. Medical accountants have been made aware of this form.

BMA Research Grants

Reminder that the deadline for applications for research grants totaling approximately £500,000 is 12 March 2010. Subject specifications for each grant vary. For example, in 2010, research areas include heart disease, cancer, inflammatory bowel disease and schizophrenia. More information on the grants on offer in 2010 and details of how to apply here.

Consolidated SFE

The consolidated SFE, taking into account amendments to the end of 2009, can now be found here.

Bulletin 46

17.02.10

NHS Appraisal Toolkit

Last week the government announced that they have identified a security problem with the NHS appraisal toolkit. DoH have released this statement. As a result of this, the toolkit is to be shut down for three weeks, so that the suppliers can modify it to ensure security. There is advice for GPs from the people who run the toolkit at its website and in this FAQ document. Please note that the option given for accessing appraisal documentation when the website is down appears to involve sending and receiving information by registered post.

There are two clear aspects to this problem - data security and the appraisal itself. Taking these in turn:
Data Security
GPC have been unable to ascertain exactly how long the security problem existed for before it was identified yesterday. However, they have no reason to believe that an actual security breach occurred - i.e. that anyone accessed data that they were not authorised to see on any doctor(s) using the toolkit. The government have assured the GPC that steps will be taken to ensure the full security of doctors' data before the toolkit is re-launched. It is expected that this will take about three weeks.
Appraisal
The shutting down of the toolkit will affect the appraisal of any GP who uses the NHS appraisal toolkit, and whose appraisal is due to take place during the three week period (and possibly after). GPs who are unable to participate in their arranged appraisal due the toolkit being shut down should organise an alternative date for their appraisal. PCTs are being told about this tonight and are being told to be reasonable.

This situation may lead to some GPs being unable to meet the normal deadline for the completion of their appraisal through no fault of their own. The GPC have written formally to the Department to ask them to write to all PCTs, advising them to be flexible in their use of appraisal deadlines for any GPs affected by the problem. They have also asked for any costs incurred by appraisers and appraisees to be met, as well as re-affirming the importance of the security of information uploaded on to the toolkit. They have not asked them to revise the three week shut down period, due to the importance of the security problem being resolved properly.

Pandemic Flu - prescribing antivirals

The DH has sent guidance on the prescribing of antivirals to SHAs, which can be accessed here.

QOF Topic Suggestion

NICE has opened the second of topic suggestion for the 2012/13 Quality and Outcomes Framework (QOF). The online topic suggestion facility allows stakeholders to submit suggestions for new indicators for QOF based on NICE guidance or other NHS Evidence accredited sources. Health professionals, patients, community groups and voluntary organisations are being encouraged to contribute. This phase of topic suggestion is open from Monday 8 February 2010 until Monday 8 March 2010.

The online topic suggestion facility provides a list of evidence-based recommendations drawn from NICE clinical and public health guidance that could provide potential new QOF indicators. This facility will be expanded to provide the opportunity to suggest a wider range of evidence-based sources, accredited through NHS Evidence. When this four-week period closes each suggestion will be reviewed against criteria provided in the submission form and suitable suggestions for the QOF will be presented to the independent advisory committee for consideration. The indicators for the 2012/13 QOF will be the first set to pass through the new NICE process in full, and the topic suggestion represents the first stage of their development. The facility can be accessed here.

The online facility to comment on QOF indicators is continually available on the NICE website and enables people to input into the review of existing indicators, this can be accessed here.

Comments will be used to review existing QOF indicators against criteria including, evidence of unintended consequences, significant changes to the evidence base or changes in current practice. Comments will be fed into a rolling programme of reviews and considered by the independent Primary Care QOF Indicator Advisory Committee. The recommendations of the Advisory Committee will then be fed into negotiations between the NHS Employers and GPC. If you have any queries contact NICE at: qof@nice.org.uk.

Final Seniority Figures 06/07

The Final Seniority Figures for 2006/07 For England have now been published by the Technical Steering Committee. The figures are £92,140 for England and £82,399 for Wales. Further details are available on the NHS Information Centre's website.

Vault Smears

Within the national cervical screening programme, the responsibility for follow-up vault smears has been shifted from GPs to the gynaecologists who performed the hysterectomy. We want to ensure that GPs are aware of this change, as some women requiring vault smears may not be called for them.

There are two main reasons for this shift:

1. it is essentially a post-operative follow-up issue, as if there has been incomplete excision of neoplastic changes, this will require further intervention by the gynaecologist;
2. there has been considerable difficulty in performing vault smears (knowing which part of the vault to smear and ensuring that the 'corners' of the scar are adequately sampled); this is very difficult to do properly in the primary care setting, so national advice is now that it should be done by colposcopic viewing and sampling, thus ensuring a good valid sampling and greater safety for the patient.

• Ensure the poster is displayed prominently in public areas and that leaflets are easily available for patients to take away. More copies can be ordered at www.lookafterournhs.org.uk, or by emailing info.lookafterournhs@bma.org.uk
• Be prepared to talk to your patients and staff, when appropriate, about the issues.
• If you’ve not already shared your views and experiences of market reforms with us, please complete the simple questionnaire in your mailing pack; you can also do this online at www.lookafterournhs.org.uk
• Help spread the campaign by putting the web address – www.lookafterournhs.org.uk – and campaign message ‘Stop big business profiting from our NHS’ on all outgoing emails.

Bulletin 45

09.02.10

Pandemic Flu - Claiming DES Payment and HPA Questionnaire

Following a query where some practices thought that the wording in the H1N1 vaccination DES around validation and payment meant that practices had to provide written information to PCOs, the DH has confirmed that this is not the case and if an extraction process (such as the FHSA) is available, then using this route is acceptable. This is outlined in this letter which has been sent to SHAs.

Some practices have received a questionnaire from the Health Protection Agency (HPA) to evaluate swine flu vaccine efficacy following confirmed cases of swine flu in their area. This is a sampling exercise and the questionnaire is in effect a ‘Yellow card’ form because the vaccine is new. We believe it would be good practice to fill in such a form, and no fee can be charged by the practice for doing so.

GP IT System Survey

NHS Connecting for Health is undertaking a survey of GPs and their staff to gain an insight into opinions on various parts of the GP IT service. It will be used where appropriate to inform discussions with suppliers and enable service improvements in the most valuable areas. Please spare 10 minutes to complete the survey and there is space at the end to add additional information. It is open until Friday 5 March and can be accessed here.

GP Employment Law Courses

This is a reminder for a series of BMA 1 day courses that you may find useful. They cover key issues in employment law - managing change, performance and staff. Further details can be found here.

Bulletin 44

02.02.10

Kings Fund Inquiry Survey

The King’s Fund has launched an on-line opinion survey about the quality of care in general practice. It is absolutely essential that every GP responds to this in order to ensure GP opinion is heard. Please contribute to the survey here. Full details of the inquiry are available here.

Pandemic Flu - planned stand down of NPFS 11 February

Due to the decrease in the number of H1N1 cases over recent weeks it has been decided to stand down the NPFS web and phone service, effective from 1am on 11 February 2010. You will need to ensure communications to patients - including websites, posters and leaflets - exclude reference to NPFS, and that you can respond to any H1N1 queries. Note that the service can be restored in seven days, should it be needed. Further information and a communications check list for practices and PCOs are available in Ian Dalton’s letter here and by following this link. A reminder that locally the ACP at Primecare has now closed and 4 pharmacies are now providing this service (PCT are contact for further details if required).

Revalidation Update

You can view the latest edition of the BMA's Revalidation Newsletter here.

National Audit of Fall and Bone Health in Older People

This letter from the Royal College of Physicians provides outline information with regard to a national clinical audit that will take place between September and December 2010. You may be contacted regarding a small number of patients in this audit period.

GP Health offer CBT

GP Health have now extended service to include Cognitive Behaviour Therapy (CBT). Visit their new website for details on this and the other services they offer.

Survey for Sessional GPs

As part of a GPC review into the arrangements for the representation of sessional (salaried and locum) GPs within the GPC and BMA, and at a local level, a working group has put together a survey that will be sent to sessional GPs, who are members of the BMA, next week. The survey will be vital in informing the working group and helping it make recommendations on how sessional GPs will be represented at a national and local level. The results of the survey will also be used as part of next year’s evidence to the Doctors and Dentists Review Body (DDRB) on the remuneration and working patterns of sessional GPs. We would very much encourage sessional GPs who receive the survey to take the time to complete the questionnaire. Sessional GP members who have not received the questionnaire by the end of February, or have questions about this process should contact the BMA’s research department at: info.hperu@bma.org.uk.

Sessional GPs Newsletter

The Sessional GPs Newsletter, Winter 2010, can now be viewed here. Issued quarterly the aim of this newsletter is to keep sessional GPs up to date with the broad range of new and ongoing issues affecting them, and the hard work that the Sessional GPs subcommittee undertakes on their behalf.

Bulletin 43

19.01.10

HMRC New Penalty Regime Briefing

Last week I sent some very important information from the GPDF regarding HM Revenue & Customs' new powers, procedures and penalties. For ease it has now been loaded on our website here. We strongly recommend you read and take on board this information as errors in tax returns could have serious consequences, for both individual GPs and their practices. You must ensure that you are fully compliant or a likely consequence may be referral to a GMC Fitness-to-Practice hearing.

'Your Surgery, Your Say' poster and leaflets

Last year the government imposed several changes to the patient experience survey. A by-product of these changes was that some practices ended up losing a significant element of their funding, partially because of low response rates among patients. In order to help address this problem, GPC has developed the 'Your Surgery, Your Say' poster and leaflet for practices to display in their surgery.

The poster and leaflet explain what the practice is doing to offer patients the best possible access, and also explains how patients can give their views directly to the practice. The poster also reminds patients of the importance of completing the Government's patient survey, and explains directly what many might not understand - that their practice's funding depends on their responses. Copies of the poster and leaflet should have arrived at your practices on either Friday 15th January or Monday 18th January. Electronic copies of the poster and leaflet are available here where you can print additional copies for display.

Bulletin 42

12.01.10

084 Number Guidance

A ban on 084 telephone numbers that charge the public or patients a premium rate came into force 21 December 2009. However, 084 numbers that are no more expensive than the equivalent of a local call can continue to be used. There are a few practices in Tees that have 084 numbers and we believe the PCTs were working with these practices directly in preparation for the ban. We advise practices to get, if they haven't already, a guarantee with regards to appropriate call charges from their 084 number supplier. Please ensure you are familiar with the following documents and are operating within the guidelines.

DH’s response to 084 consultation

Directions to NHS bodies concerning the cost of telephone calls in relation to health services - 21 December 2009

GPC Practice Finance subcommittee guidance on the use of 084 numbers in the NHS

Updated Disability Discrimination Act Guidance

The original DDA guidance for GPs, published in 2003, has now been updated. You can access the revised guidance, The Disability Discrimination Act: Physical adjustments to GP premises required under the Act, here.

Flu Respirator Fit Testing Leaflets and Posters

The DH has published downloadable posters and leaflets on how to use and fit test FFP3 respirators when carrying out aerosol-generating procedures patients with symptoms of influenza.

BMA 2010 Research Grants - available to apply for now

The 2010 research grants are now available to apply for online. Applications are invited from medical practitioners and/or research scientists and are for either research in progress or prospective research. The application deadline is 12 March 2010. Subject specifications for each grant vary. For example, in 2010, research areas include heart disease, cancer, inflammatory bowel disease and schizophrenia.

For more information on the grants on offer in 2010 and details of how to apply, click here. Around 11 research grants are administered under the auspices of the Board of Science, all funded by past bequests to the BMA. Grants totaling approximately £500,000 are awarded annually.

2010/11 GMS Negotiations

Following negotiations between the GPC and NHS Employers, five existing Directed Enhanced Services (DESs) due to finish in March 2010 will be extended for a further year for 2010/11. There will be no other changes to the GMS contract next year, with the intention that practices experience a period of contract stability. The five DESs that will be extended to 2010/11 are the:

• Extended Hours Access Scheme DES
• Alcohol DES
• Learning Disability DES
• Osteoporosis DES
• Ethnicity DES

Bulletin 41

05.01.10

Pandemic Flu - dosage schedule update and revised version of clinical management guidelines

The licence for Pandemrix has now been amended to allow one dose (0.25ml) in children. Patients who are immunocompetent and who have already received one dose of the vaccine do not need a second dose even if this has already been scheduled. Immunocrmpromised individuals should still receive a second dose as scheduled. Further details here.

The DH has published revised versions of the Pandemic H1N1 2009 influenza; Clinical management guidelines for adults and children. The change is in paragraph 5 on page 9, which has been extended to define what 'high dose' means in the context of this document.

The DH has also updated the Pandemic H1N1 2009 influenza: Clinical management guidelines for pregnancy. There are two changes: a footnote has been added to paragraph 5 on page 17 reflecting the different requirements of the abortion legislation in England and Northern Ireland; they have also added a new paragraph 5 on page 19 to deal with the outcome of the ORACLE study which implicated co-amoxiclav with necrotising enterocolitis in preterm rupture of membranes.

QOF Business Rules

Version 16 of the business rules has now been published and is available here. Please note that for the QOF CVD PP1 indicator (Cardiovascular disease - primary prevention 1), the business rules have been amended to exclude patients under 30 years of age from indicator PP1. The age range for this indicator is now set as 30-74 years. Patients outside this age range should still be individually assessed and their risks reduced, although risk equations do not apply and thresholds for reductions are not currently available. PP2 applies to all age groups, as do the blood pressure control indicators in the hypertension set.