2
Doncaster Local Medical Committee Ltd
Oakwood Surgery, Masham Road, Cantley,
Doncaster DN4 6BU Tel: 01302 320010. Fax: 01302 371804
Lay Secretary – www.doncasterlmc.co.uk
UPDATE April 2014
Contents Page
1. DDRB Pay award …………………………………………. 2
2. Motions for conference ………………………………….. 2
3. GPC Vacancy for South Yorkshire …………………….. 3
4. New models of general practice ………………………... 3
5. Primary care Commissioning courses ………………… 4
6. New contract changes – what to do now ……………… 5
7. Unplanned admissions – Enhanced Service …………. 6
8. Care.data ……………………………………………………. 6
9. CQC Consultation on regulating general practice ….. 7
10. GP trainee framework contract …………………………. 7
11. Federated Flexiplan Pension Scheme …………………. 7
12. Vacc and Imms ……………………………………………... 7
13. Electronic Prescription Service EPS2 …………............. 8
14. NHS Prescription charges ……………………………….. 9
15. Joint report on obesity services ………………………… 9
16. Trade waste ……………………………………………….. 10
17. Commissioning/Procurement opportunities ……….. 10
18. Correspondence received ……………………………… 11
19. Job Vacancies ……………………………………………. 11
20. Condolences, Welcomes, Congratulations …………. 15
DDRB Pay award 2014/15 and 2015/16 announced
The DDRB have recommended an uplift of 0.28% to be applied to the overall value of GMS contract payments for 2014-15, intended to result in an increase of 1% to GP contractor income after allowing for movement in expenses. This was due to an apparent reduction in practice staff costs, using the data Annual Survey of Hours and Earnings. The GPC do not agree that a 0.28% uplift to the contract value will produce a 1% increase in contractor income, and are looking at ways to challenge this figure.
For salaried GPs, the DDRB recommended that the minimum and maximum of the salary range should be increased by 1% for 2014-15.
For the trainers’ grant, the DDRB recommended an increase of 1% along the same lines as basic pay for other doctors. Given ongoing doctors in training contract negotiations, no recommendation on any change to the GP specialty register supplement has been made. It will remain at 45%.
Motions for Conference
On your behalf, Doncaster LMC has submitted the following motions for consideration at this year’s LMC Conference in May.
1) Conference recognises and resolves to have the GPC publicise that the year on year erosion of general practice income has resulted in primary care job losses causing GP stress and burn out and risks serious long term staffing deficiencies within General Practice.
2) Conference has spent the last year in dismay: witnessing fragmentation of commissioning in the NHS and calls upon the GPC to encourage the strengthening of ties and improvement in communication between commissioners and General Practice.
3) Conference is deeply concerned by a number of CCG’s who have failed to engage LMCs in matters concerning GPs and demands that CCGs recognise and engage LMCs as the statutory body of local GPs.
4) Conference deplores the continued reduction in investment in General Practice which poses a serious threat to the viability of the future of the NHS and demands:
i) Immediate action by the Government to provide financial help to General Practice.
ii) A commitment to safeguard General Practice from future budget cuts.
5) Conference has grown tired of the relentless attack on General Practice over the last year, scapegoating GPs for the worsening crisis in the NHS and calls upon the GPC to undertake a primary care workforce census to help inform the Government, Media and Public of the current pressures in primary care staffing.
6) Conference has recognised that the negotiators exert excessive influence to the outcome of a motion when summing up. Conference asks the GPC to impartially reflect the sentiments of a motion when summing up rather than giving opinion and direction so that conference can find its own voice.
7) Conference recognises that England, Scotland and Northern Ireland are not ‘Londonland’ and calls upon the GPC to remind national policy makers that policies modelled upon behaviours of the London populace are unlikely to be useful across the rest of the UK and as such require local influence.
8) Conference recognises that DDRB pay recommendations do not reflect NHS GPs pay as they are based upon income drawn from HMRC tax returns which includes both NHS and private incomes and as such calls upon the GPC to negotiate with the Government a new means of assessing GPs NHS income.
9) Conference is appalled that NHS England have chosen to withdraw discretionary payments for the disposal of trade waste and calls upon the GPC to safeguard future remuneration to practices for the disposal of waste associated with the business of carrying out NHS General Practice.
GPC VACANCY FOR SOUTH YORKSHIRE – Candidate Dr Dean Eggitt
The ballot for the South Yorkshire vacancy on the GPC closes on 25th April. If you have not already voted could we urge you to do so, or if you have not received a ballot paper please let us know.
NEW MODELS OF GENERAL PRACTICE
The HSJ has published a map of England showing the rise of GP federations and provider companies. The map – which HSJ concedes may be incomplete – shows 1.86m of the population already served by general practice groups and underlines a growing trend as practices respond to the business need to scale up and to external pressures to provide a wider range of services beyond the scope of the single practice. PCC can provide support to help CCGs and groups of practices around the country debate their options and make plans for federation and other forms of collaborative working.
Primary Care Commissioning Courses
Primary Care Commissioning are running a programme of workshops to support practices.
There are two key topics:
Working in General practice:
-getting the legal structure right
- understanding GMS changes 2014/15
Working together in general practice: getting the legal structure right
GP partners and practice managers need to understand the different models available and how to choose the one that will work for them. The preferred solution must be underpinned by suitable legal arrangements and agreements.
This workshop covers:
• Different models of working together
• Pros and cons of merger, federation and formal provider entities
• The alternatives: limited companies, social enterprises and others
• Considerations for procurement and ownership of practice lists
• Timescales and resource implications
• Key factors in making the right decision.
2 April, London https://www.pccevents.co.uk/pcc/946/home
3 April, Leeds https://www.pccevents.co.uk/pcc/947/home
29 April, London https://www.pccevents.co.uk/pcc/948/home
30 April, Birmingham https://www.pccevents.co.uk/pcc/949/home
There is a code for LMC members to access these at a discounted rate - use the following code when booking up: LKLMC
Understanding GMS changes 2014/15
April 2014 has brought major changes to the GP contract regulations including reductions in QOF indicators, new incentives for reducing emergency admissions, a named GP to coordinate care of older patients and changes to services for patients registered out of the area.
Understanding the financial implications of the GMS contract changes including the opportunities for support to general practice through re-investment in the "global sum" is crucial for area teams responsible for commissioning primary care, CCGs seeking to enable primary care development and GP contractors themselves.
There is also need to understand the significant implications of the 2013 premises costs directions.
This event will allow delegates to hear directly from NHS England about how the GMS contract changes will be managed, the implications of changes to the "statement of financial entitlements" and the requirements for the new enhanced services. PCC experts will advise on the detail, answer queries and help delegates to consider the planning implications.
Event links are:
Leeds, 1 May 2014 https://www.pccevents.co.uk/pcc/957/home
London, 8 May 2014 https://www.pccevents.co.uk/pcc/962/home
To access the discounted code when booking use: GMSLMC
Further information: Sally Simmonds, Development Manager, PCC, tel 07920 500139.
Future strategy for commissioning general practice services
NHS England has published outline details of a strategy for commissioning general practice services. Building on the “call to action” for general practice, the report focuses on the central role NHS England wants general practice to play in wider systems of primary care.
http://www.england.nhs.uk/wp-content/uploads/2014/03/emerging-findings-rep.pdf
New contract changes – list of actions that practices can carry out now.
1) Allocate named GP to patients aged 75 and over and tell patients who their named GP is by end of July or within 21 days of registration
2) Sign up to voluntary unplanned admissions enhanced service if your practice chooses to do so. Establish elements of the enhanced service, eg identification of 2% case management register, creation of care plans, bypass number for external healthcare providers and appointment of named GP and care co-ordinator by end of July.
3) Ensure your practice is ready for new regulations on patients and information, including electronic appointment booking, requesting online repeat prescriptions and access to summary information on the patient record.
4) Work out how the changes to seniority will affect you and your practice
5) Ensure your practice has systems in place to meet requirements on the quality of out of hours services, which the majority of practices will already be doing.
6) Be aware of changes to the Extended Hours enhanced service. This now allows practices to collaborate and provide extended hours in networked arrangements, rather than having to provide it by individual practices specifically.
7) GMS practices – check the financial impact of the movement of QOF and enhanced services resources into core funding (there is an NHS ready reckoner).
8) PMS practices – check how the contract changes will be applied to your practice funding.
Unplanned admissions – enhanced service
Practices should now have received guidance on the Unplanned Admissions Service which is available at http://www.nhsemployers.org/SiteCollectionDocuments/Avoiding%20unplanned%20admissions%20guidance%202014-15.pdf
The templates which are linked to this Service can be downloaded at:
http://www.nhsemployers.org/PayAndContracts/GeneralMedicalServicesContract/DirectedEnhancedServices/Pages/Enhancedservices201415.aspx
Please note that Care Plans for patients do not now need to be in place until the end of September 2014, (not June 2014 as originally planned). Also, a named accountable GP and care co-ordinator for patients under 75 yrs does not need to be in place until the end of July 2014 (not June 2014 as originally planned). However, patients 75 yrs and over, will still require to be informed of their named GP by end of June for existing patients, or within 21 days for new registrations, in line with the GMS and PMS regulations for a named GP for patients aged 75 and over.
Care.data
The extracts for care.data are now due to take place in autumn 2014, following the announcement by NHS England that there would be a delay to the extract to allow further time to respond to the concerns of patients and GPs about the scheme. Further negotiations with NHS England and the Government are underway.
How to take part in the CQC Consultation – New approach to regulating, inspecting and rating general practice.
A formal consultation has commenced on how CQC will regulate, inspect and rate care services from October 2014. The draft guidance for general practice has been published on the CQC website, and includes an overview document, a draft GP practice and GP out of hours inspection handbook, and alongside these documents the CQC approach to human rights, etc. The consultation will run until 4th June. There is an online feedback form on the website and in addition, a series of dates of events across the country during the consultation period.
http://www.cqc.org.uk/public/get-involved/consultations/consultation-how-we-regulate-inspect-and-rate-services
GP trainee framework contract
The GP trainee framework contract has been updated by the GPC and COGPED to bring it in line with current legislation and terminology. The changes to the framework are not the result of a negotiation and are in no way connected to the ongoing negotiations for a new contract for all doctors in training. We recommend that the framework is used for all GP trainees. The updated framework can be found on the BMA website.
Federated Flexiplan No. 1 Pension Scheme
This industry-wide occupational pension scheme covers workers in the health and education sectors and was set up in 1966. The scheme is currently being wound up, having closed to future accrual on 1.2.10, with a deficit of approximately £20 million.
The BMA GPC would like to hear from any practices that are members of the scheme that may have been affected by increasing cost liabilities as a result of the deficit. Please contact
New vaccination programmes commencing 1 April 2014
Hepatitis B for new born babies at risk (SFE) - guidance published.
MenC vaccination booster for freshers (ES) - guidance and service specification published.
Existing vaccination programmes continuing from 1 April 2014
MMR (SFE) - for patients over 16 who self present at practices (this was an enhanced service in 2013, but has now moved to the SFE, so no new service specification will be published).
Pertussis for pregnant women (Temporary ES) - service specification 2014 has been published.
Rotavirus (SFE) - guidance published.
Existing vaccination programmes continuing after August 2014
Seasonal influenza for at-risk patients (DES/ES) has been widened so that it mirrors the at-risk groups set out in the Green Book to include pregnant women, but excluding 2-4 year olds - guidance and service specification to be published in June 2014.
Childhood seasonal influenza (ES) - this has been extended to include children aged 4, so that the new cohort is children aged 2-4 - guidance and service specification to be published June 2014.
Pneumococcal (DES) - There is an addition to programme to include the cohort as indicated within the Green Book - ie those aged under 65 in the at-risk groups - guidance and service specification to be published June 2014.
Shingles (routine cohort patients aged 70, SFE; Catch up programme (patients aged 78-79, ES) - Guidance and service spec to be published soon.
Men C for freshers (England) A tripartite letter (England) has been sent out to practices regarding the new Men C for freshers. This is a booster offered to freshers (aged 17-25) not previously vaccinated with Men C since reaching age 10, and who self-present to the practice (they will be notified via UCAS). It will commence 1 April 2014 and run until 31 October 2014. There are no call and recall requirements, the vaccine will be centrally supplied, and there will be a payment of £7.64 per dose.
Joint guidance and a service specification are being drafted and should be finalised shortly.
Public Health Vaccine Update -
https://www.gov.uk/government/publications/vaccine-update-issue-213-march-2014