Local Medical Committee Meeting1 July 2014
MINUTES OF THE COUNTYDURHAM AND DARLINGTON LOCAL MEDICAL COMMITTEE HELD ON TUESDAY 1 JULY2014 IN THE BOARD ROOM AT APPLETON HOUSE
Present:
James McMichaelChair
David Robertson Hon Secretary
Tanya JohnstonCLS
Richard HarkerDarlington
Rob CowleyDerwentside
Jon LevickDerwentside
Rushi MudalagiriEasington
Kamal SidhuEasington
Norbert DielehnerSedgefield
Mike SpenceSedgegfield – Practice Manager
Robin Wade Sessional
Claire ElderLMC
Invited:
Janet KingNHS England
Allyson McLeod-HardyNationalSkillsAcademy
Barbara GallweySafeguarding
Liz HerringND CCG
Joe ChandyDDES CCG
Numbers / ItemL14/67 / Apologies for Absence
Fiona McConnell (CLS)
Donna Boyd (Durham Dales)
K V Reddy (Easington)
Heather Prestwich (Sessional)
David Graham (CCG)
Andrea Jones (CCG)
Tom Hunt (CDDFT)
Prof Christopher Gray (CDDFT)
L14/68 / Minutes of the Meeting held on 3 June 2014– were signed as an accurate record.
L14/69 / Matters Arising
Paperless Records – the matter is still on-going.
Flu Vaccinations – Although LMC points about the risks and limitations of continuing provision of flu imms in community pharmacies were accepted, public health has nevertheless agreed that pharmacies will take part in the flu campaign. However data suggests that pharmacies only gave 5% of the total number of flu immunisations and practices should be encouraged to offer flu immunisations to all of their at risk patients.
ISIS – GPs will be paid at £100 per patient - pending an assessment of the workload involved. Concernswere expressed for practices who have nursing homes with blocks of ISIS beds within their catchment areas.
Radiology – DAR confirmed he had written to the FT.
PMS Review – It seems likely that the ‘Essex model’ is being discussed at present and that further information was anticipated at the regional LMC.
Property Services – Representatives of the AT had confirmed that the survey is to decide where the any money for premises development needs to be invested. However it had been pointed out to the AT that practices response to the questionnaire might not provide accurate information for this purpose. The amount of money for investment is likely to be very limited in any event. MS confirmed that some Practice Managers had refused to complete the sent survey.
Enhanced Services – Arrangements for out of area patients had yet to be disclosed.
L14/70 / Care.data
Janet King attended from NHS England with regard to the contentious issue of care.data. JK wanted to hear all views and everything would non-attributable so members were asked to speak frankly and freely.
Care.data was for secondary use and not for direct clinical care. Care.data was still going through a consultation and engagement phase. Pathfinders would be in place shortly for a phase in during the autumn (possibly October) time.
Confidentiality
Data came under the following banners:-
Identifiable
Pseudonymised
Anonymised
GP data
HSCIC data
Members were concerned with patients’ data being used and who was responsible for telling patients. Janet King confirmed that presently it is the Practices responsibility to inform patients about care.data and opting out as NHS England did not have capacity to do so.
There would be a publicity process to include posters and information on the NHS England website. Letters will need to be sent out also. Pathfinders will test all of these processes out.
JK confirmed that certain data would presently not be allowed to be requested, ie GUM clinics. Some data would flow in to the centre but would not flow out. Members expressed concerns around the conflict between their legal obligations under the Data Protection Act and the Health & Social Care Act whereby GPs could breakthe law if they didn’t share information but could breakthe law if they did! JK confirmed that now the Health & Social Care Act would take precedence.
Concern was raised with JK about patients being confused with the option to share their data for several different reasons: Summary Care Records, Care.data, and data sharing relating to clinical software.
JK reported that lessons had been learned with regard to data disclosure and insurance companies would have no information shared with them.
Members expressed concern that doctors would record less personal information in case it be later used for purposes for which it was not meant. Concern was also raised that if the data-set could be changed it would be changed in the future and in this case how would patients be notified? JK explained that patients could look for data-set changes by looking at the NHS England website. The committee felt that this was not a robust way of ensuring continuing consent by patients.
Members asked who would be supporting GPs with this process, and again it was pointed out that NHS England did not have the resources at present and JK looked after the Northern Region (from the top of Wales and including Scotland) by herself with no support! JK recognised that GPs had very little capacity within practice also.
Members felt that this data should be properly paid for – JK explained that at present this might not look well with the public and therefore there was only a nominal fee to cover administration. JK informed the committee that those who deal with the requests are an independent committee from HSIC and NHS England. Membership is looking to be expanded and lay representatives will be required. This group is also being looked at because at present it is very hard to identify who is on this board. Funding for this group comes from NHS England and the Cabinet. Members wondered what the figure of opt-out would have to before Care.data was scrapped.
Expressions of interest from practices to be pathfinders were presently being looked for.
There would be no extraction of information until pathfinders have fed their information back.
L14/70 a / NationalSkillsAcademy - Apprenticeships
Allyson McLeod- Hardy attended from the NationalSkillsAcademy to encourage GP Practices to think about taking on an apprentice. This agency is backed by the government and is being set up to make it easier to access help and advice and training for the health sector.
Allyson encouraged practices to contact her to tell her their experiences with this scheme. She wanted to know what barriers prevented Practices taking on an apprentice. She also wanted to identify good practise so that these ideas could be used and encouraged elsewhere in other practices.
Apprentices needed to be contracted for 366 days minimum and would be trained to Level 2/3 and given extra help with functional maths and English. A mentoring system would also be in place.
MS agreed to contact Allyson and liaise as Practice Manager Lead.
L14/71 / Secondary Care
The representatives from the FT sent their apologies but have agreed to attend in September.
L14/72 / Area Team
L14/73 / Primary Care Support
L14/74 / Clinical Commissioning Groups
74.01 Safeguarding Children – Domestic Violence Recording
Barbara Gallwey and Liz Herring attended to update the Committee on the work they had been doing with regard to domestic abuse recording within GP records.
BG explained that last July they had produced a document regarding domestic abuse and recording thereof. During a meeting in October at the ND CCG it was decided that coding needed to be made clearer for alleged perpetrators. In the very near future Practices will start to receive reports on domestic events.
On average there are 14,000 recorded incidents of domestic violence within County Durham & Darlington during one year. Senior Police Officers will assess and will record them as:-
- Standard;
- Moderate; or
- High Risk.
Record Keeping – practices are advised to code “alleged perpetrators” (but not on the front of the screen). An icon will be on screen for System 1 but at the moment there is no similar function for EMIS, although work is going on nationally to develop this. Code will be HARKS.
Advice is that localised codes should not be used as this can be lost in translation when patients move to other practices. Concerns was raised by members that alleged perpetrators will eventually find out what the new coded symbol means and will object.
Perpetrators will be screened for risk several times by the Police so assessments will have been made not by the practice but by the Police.
Members wondered if there would be training and support for Practices with these changes to safeguarding issues.
BG confirmed that the document was still in progress but wanted to know whether the Committee supported the document. Members agreed to fully support the document.
74.02 Primary Care Strategy – DDES
Joseph Chandy attended and explained that both DDES and ND have produced their Primary Care Strategies in total isolation but basically are very familiar and have many issues in common both regionally and nationally.
Nationally and locally issues are:-
IT
Recruitment and Retention
Co-Commissioning
CDDFT – Presently there is no agreed contract. The CCG would like to continue the block contract whereas the FT would like to move to PBR. The matter has gone to a conciliation process but if this fails and it goes to arbitration it will cost both sides £100,000.
ISIS – Underway at present.
Federations–within DDES there are three established Federations:-
Intrahealth
Durham Dales
Easington & Sedgefield
L14/75 / Out of Hours
L14/76 / Communication from the BMA/GPC
L14/77 / General Correspondence
L14/78 / Any Other Business
L14/79 / Date, Time and Place of Next Meeting
2 September 2014 @ 19.30 in the Board Room at Appleton House
Private and Confidential
Ref: CNE/MINUTES/AGENDAS/LMC/Minutes 2014