Newcastle and North Tyneside
Local Medical Committee
http://www.nntlmc.co.uk
LMC Newsletter November
2017
State Backed Indemnity Scheme.
Recently the government pledged to roll out a state backed clinical negligence indemnity scheme for general practice in England. This move came after months of sustained lobbying by the BMA’s GP committee and calls from GPs across the country for government to recognise the scale of rapidly increasing indemnity costs over the last few years ((50% between 2010 and 2016).
Following the DH announcement, MDU advised that its membership benefits for GPs working under an NHS England contract who renew/join after 1st Nov will change to ‘Transitional Benefits’ intended to provide the indemnity until a state-backed scheme is introduced. Yesterday the Department of Health directly addressed this offer by amending its indemnity factsheet
For ease of reference the current views/positions of the three MDOs are available below:
Medical Defence Union
Medical Protection Society – and its comment on the MDU offer
Medical and Dental Defence Union of Scotland – and its comment on the MDU offer
With the above information in mind, we would like to remind GPs of the requirement to maintain full indemnity cover before any change to a state-backed scheme in the future.
Did Not Attend (DNA) Numbers.
As winter approaches and workload increases we are very aware of the struggling capacity of general practice to cope. The LMC would like to publicise the number of wasted appointments that happen in practices. Many practices keep this information so we would like some figures from as many practices as possible about the average number of DNAs per week. Please supply numbers and rate/1000 patients to allow extrapolation.
If you are willing to share your figures please send the information to
NHS Rules for Charging Overseas Visitors – where do GPs stand?
T he regulations now pace a legal obligation on secondary care to establish whether the patient is an overseas visitor and entitled to non –urgent NHS treatment. However patients can still receive free care from their GP regardless of their rights to live within the UK, as there is no minimum period that a person needs to have been in the UK before registration at a practice. Practices may decide to register them as a full or temporary patient.
· GPs are not responsible for deciding whether patients are eligible for free secondary care
· GPs now provide the new GMS1 forms that include a number of non-obligatory questions to determine eligibility
· GPs are not compelled to include any relevant information when making referrals
· If refused treatment and unwilling to pay then GPs will be informed and may have to manage the condition themselves until it becomes urgent, when they can refer!
· Exemptions –refugees, asylum seekers, children in care of LA, victims of modern slavery
Annualisation within the 2015 Pension Scheme.
Since 1 April 2015, GPs in pensionable employment who transitioned to the 2015 CARE scheme have been required to determine their pension contribution tier based on annualised income (rather than actual income) if they have had breaks in service.
The following guidance which is now available on the BMA website.
https://www.bma.org.uk/advice/employment/pensions/annualising-of-2015-scheme-contributions
New guides support GP staff to increase accessibility.
NHS England has launched four free GP staff accessibility guides at this year’s Health and Care Innovation Expo. Designed to support staff to increase the accessibility of GP services to patients with disabilities, the guides contain practical advice to improve your practice website, communication with patients and enable the use of accessible technology.
The staff guides, developed with Action on Hearing Loss, Change, The National Autistic Society, RNIB and Sense, are further supported by several new easy to read GP online services patient booklets.
Find out more and order your free guides, using this link https://www.england.nhs.uk/patient-online/support/
Peer Review GP Referrals.
A NHSE document from earlier this year compelled CCGs to have in place a scheme to peer review GP referrals before they are sent. As aresult of this there have been discussions between the GPC, NHSE, and NHSCC (representing the CCGs) and an extract from a letter to CCGs is below.
“Firstly, there are a number of referrals that should bypass the clinical peer review process. These include 2WW cancer referrals, other urgent referrals, referrals going through an MSK Triage (or other commissioned specialist triage) and those following receipt of Advice & Guidance from a hospital consultant. CCGs can agree additional local exceptions.
Secondly, we must emphasise that we are not expecting clinical peer review to be implemented in every practice in every CCG. CCGs with a good track record of managing referrals may want to use some aspects of the guidance using a more retrospective developmental approach to support practices, including the use of data on significant variations. We expect that CCGs where there are more challenges with referrals, particularly those with high rates of growth, should adhere more closely to the guidance. If external review shows that high referral rates are clinically justified, then a differential approach can be taken.”
The LMC hopes that there has been enough movement from NHSE to allow CCGs who wish to follow a more moderate path to do so.
Criminal Finance Act 2017.
The Criminal Finances Act 2017 introduces two new criminal offences - one applying to the evasion of UK taxes and one applying to the evasion of foreign taxes.
The offences hold corporations and partnerships criminally liable when they fail to prevent their employees, agents, or others who provide services on their behalf from criminally facilitating tax evasion. This is a significant change from existing law under which they can only be found liable for criminally facilitating tax evasion if the most senior members of the organisation – typically the board of directors - are aware of the facilitation.
GP Survival SAR (Subject access request) campaign.
There are reports from up and down the country of doctors sending their pension contributions to PCSE (Capita) and receiving no confirmation that the payment has been received, nor added to their pension.
Inquiries by GPs to PCSE yield little information so a member of the GP Survival forum has come up with the rather outstanding idea of sending a subject access request (SAR) to PCSE to demand details of all pension payments made on their behalf. This means PCSE are legally required to provide this data within 40 days, or else may be referred to the Information Commissioner’s Office (ICO) for breach of the Data Protection Act. Even if they reply in time, but with inadequate data then they could be referred to the Financial Ombudsman.
Any GP wishing to undertake this process can look at GP Survival at https://www.generalpracticesurvival.co.uk/ or contact the LMC for further information at
Troponin T requests in Primary Care.
As issue has arisen when a practice orders a troponin T test and the result comes back to the out of hours organisations when they have to track down the patient and usually admit. Discussions have been held with secondary care and the consensus of opinion is that this test has very little place in primary care as if a cardiac problem is suspected then admission should ensue and not wait for results to come back.
LMC Buying Group.
Details of the flu vaccine offers for 2018-19 for members should be arriving shortly. If a member practice doesn’t receive the details please contact the LMC at
How to Hire a Locum.
2 new videos for practice managers on how to hire locums have been prepared by Dr Paula Wright. She is the Regional Sessional GPC sub-committee representative
Part 1
https://www.youtube.com/watch?v=vjenZys-KQ4&t=631s
Part 2
https://www.youtube.com/watch?v=phoqQUrn9s0&t=1s
LMC Website Blog
This contains a lot of important information on the following issues:
· Sessional GPs eNewsletter October 2017
· Latest LMC minutes available – September 2017
See http://www.nntlmc.co.uk/blog/index.html
GPC News, GP News from the Chair and local issues.
This months GPC News contains some important information on:
No Issue
For national issues from the GPC with relevant links etc. please see the LMC website: http://www.nntlmc.co.uk/styled-3/downloads-2/index.html and http://www.nntlmc.co.uk/page55/index.html
Also please watch your LMC Blog http://www.nntlmc.co.uk/blog/index.html
Use of the LMC RSS feed on the Blog page will automate your updates.
Website The LMC now has a Facebook page: http://www.facebook.com/pages/Newcastle-North-Tyneside-LMC/252898648158228
We hope that most of the LMC’s communication will be by way of our website and that practices will use the LMC RSS Feed for automatic notification of new information.
See http://www.nntlmc.co.uk and try it out
George Rae Chief Executive Officer
David Black Executive Officer
Ken Megson Executive Officer
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