Newsletter February 2010
NHS_Appraisal_Toolkit_Downtime
Requests_from_Schools_for_sickness_certification
Warfarin_and_Miconazole_Oral_Gel
Contract Negotiations
NHS Employers and the GPC have reached agreement on the outstanding areas of the GMS contract for 2010/11. It has been agreed that the Extended Hours Access Scheme DES will be extended for a further year for 2010/11 and the four Clinical DESs will also be extended for a further year. The four DESs are
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Alcohol
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Learning Disabilities
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Osteoporosis
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Ethnicity
There will be no changes to QOF in 2010/11 in line with the H1N1 vaccination agreement
Summary Care Record
"Connecting for Health" have recently announced that they will be funding a mail shot to patients regarding the implementation of the Summary Care Record, but the funding will only be available to PCTs in the current financial year. Both Stoke and North Staffordshire PCTs are keen to take up this offer of funding and are planning to send out information to all patients in the near future although they will not be in a position to implement the SCR in all practices until later in the year.
The summary care record may have some benefits for patients, but is not compulsory for practices to take part in this. There is a significant workload involved for practices, some of which will be on going. I am informed that there is now a requirement for telephone number to be recorded in the practice clinical record in a format which includes the STD code. Changing this alone is a large piece of work, which if not completed will result in error messages being sent every time a patient's record is accessed by the practice. Error messages will also be generated every time a prescription is issued without a smart card log in. Practices will be expected to deal with the log of these errors. Some practices have decided that this extra workload is a step too far and have declined to take part in this project.
The inclusion of the telephone number in the Patient Demographics Service (PDS) was a unilateral decision made without any consultation or knowledge of the GPC, BMA or JGPITC. Although it may seem logical to include this there are concerns in that patients who have given ex-directory numbers to practices in strict confidence are now potentially having this data uploaded to the PDS without the knowledge of the patient and/or practice.
Elections to the Committee
Nominations papers have been circulated seeking nominations for the LMC. Elections take place every two years for 10 members. This year in order to broaden the representation of the committee, two places will be reserved for a female representative and one for a sessional/salaried/locum doctor. The voting papers for this election are being circulated now.
NHS Appraisal Toolkit Downtime
The government have identified a security problem with the NHS appraisal toolkit and as a result of this it has been shut down for three weeks so that it can be modified to ensure its security. The GPC have no reason to believe that any actual security breach has occurred and the government have assured them that steps will be taken to ensure the full security of data before the toolkit is re-launched.
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 in the three week period or possibly after. GPs who are unable to participate in their arranged appraisal due to this shut down should organise an alternative date. PCTs have been told to be reasonable over the problems this will cause.
The site should be back on line by 3rd March. A document produced by the Department of Health concerning this can be found here.
Requests from Schools for sickness certification
GMS GPs are not contractually obliged to provide a sick note for pupils who are off sick from school. They are also not obliged to provide sickness certification for students that miss an exam or believe their performance was affected due to illness. The same is likely to apply to other NHS GPs. Unfortunately, many GPs still receive requests for the latter.
The BMA's General Practitioners Committee (GPC) therefore wrote to the Office of the Qualifications and Examinations Regulator (Ofqual) about this, and has received a response which highlights that medical proof should not be required. If you receive a request for this, you may wish to draw the requester's attention to the letter. A copy can be found here.
Your Surgery, Your Say
Last year the government imposed, against our advice, 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 have been sent to all GP practices in England and Northern Ireland (not Scotland and Wales).The packs were posted on Thursday 14th January, and should arrive at most practices on either Friday 15th January or Monday 18th January.
Electronic copies of the poster and leaflet are available on the BMA website via this link, and practices can use these to print out additional copies for display.
Disability Discrimination Act - GPC Guidance
The GPC has updated it's guidance on the Disability Discrimination Act 1995. This Act requires providers of goods, facilities and services (which includes GP practices) to make physical adjustments to their premises to enable disabled people to use their services. This applies not only to patients using the premises, but also to staff employed by the practice. A copy of the advices can be found here.
084 Numbers in the NHS
The GPC Practice Finance Subcommittee has published guidance on the use of 084 numbers in the NHS, this is available on the BMA website and a copy can also be found here.
The DH published their response to a consultation in September 2009, which concluded that the use of phone numbers that charge the public or patients a premium rate to contact the NHS were to be banned in England. However, 084 numbers could continue to be used if call charges were no more expensive that those of the equivalent local calls.
Tax Health Plan
Medical professionals are being encouraged under a new Tax Health Plan to tell HM Revenue & Customs (HMRC) if they have understated income.
Those who contact HMRC by 31 March 2010 to make a voluntary disclosure will be able to put their tax affairs in order simply and on the best available terms.
After that date, using information it holds about how much is paid to them, HMRC will carry out targeted investigations aimed at medical professionals who have not come forward. Substantial penalties or even criminal prosecution could follow for those who have undeclared tax liabilities.
The Health Plan is the first initiative in a new HMRC campaign focused on professionals. It is designed to make it easy for customers to put their tax affairs right and keep them that way.
The aim is to make it as easy as possible for people to come forward, make a full disclosure and benefit from the certainty of a reduced 10 per cent penalty that HMRC is making available to those who qualify for this opportunity.
From April HRMC will be using the information at their disposal to investigate medical professionals who have not declared their full income. Therefore it is strongly urging any in this group who think they may have outstanding tax liabilities on their income to get in touch with them and get their tax affairs in order simply and on the best available terms.
The Health Plan will operate in two stages:
- From 11 January to 31 March 2010, medical professionals can register their intention to make a voluntary disclosure with HMRC.
- By 30 June, those who have registered must have made their disclosure as well as arrangements to pay all tax interest and penalties due.
What do you have to do to notify your intention to make a disclosure?
- Ring HMRC on 0845 600 4508, or
- Use the e-form available via the link on the HMRC website: http://www.hmrc.gov.uk/tax-health-plan/
The benefits of the Tax Health Plan are that you can avoid the possibility of:
- a penalty of up to 100 per cent of the tax due,
- an investigation resulting in criminal prosecution.
Warfarin and Miconazole Oral Gel
I have been asked by the Area Prescribing Committee to bring to your attention the risk of severe interactions between Miconazole Oral Gel and Warfarin. Cases have been reported of INRs rising to 18 and there are a number of reports of INRs rising to over 10.
Choose and Book LES
During the last few months Stoke PCT has been reviewing the calculations for the 2008/09 LES payments. The data supplied to them has been compared to data from a sample of practices and the calculations have been reviewed. The data now appears more reliable and accurate although a few final checks need to be made. Assuming that these checks are satisfactory, the PCT should be making payments for this LES in the near future. The same methodology will be applied to the 2009/10 LES. Discussions will be taking place soon on the 2010/11 LES.