June 2020 Newsletter

Included in this Edition:

  • BMA risk assessment guidance for practices
  • PPE – face masks and coverings
  • Update from ICO regarding the protection of data during the COVID-19 Pandemic
  • Covid-19 Antibody Testing for Staff
  • Covid19 Pillar 2 lab results flow into GP records
  • CPR guidance for primary and community care
  • Positive Covid-19 Tests and Life Insurance/Mortgages implications
  • Hand Sanitiser Safety Alerts
  • CQC – Emergency Support Framework (ESF)
  • Pensions guidance and update (England and Wales)
  • PCN DES (England)
  • LMC Law – Merger Advice and updated schedules for PCN network agreements
  • Named clinical lead for care homes – suggested wording for partnership agreements
  • Appraisal update
  • Homeworking Policy
  • QOF payments for 2019-20
  • Email submission of Crem 4 to West Suffolk Crematorium
  • Annual Flu Campaign 2020/21
  • Local Authority Enhanced Services
  • LMC Vacancy – Medical Director
  • Practice Vacancies

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Information, Guidance and News

Key Matters reviewed by the Committee June 2020:

  • Covid-19 matters
  • Test and Trace
  • Covid-19 Antibody testing
  • Updated Primary Care SOP – resuming routine work
  • Capturing positive support of practices during Covid
  • ICS Update
  • Test and Trace
  • Mental Health Pathway
  • Transfer of workload from Trusts during Covid 


BMA risk assessment guidance for practices

The BMA has updated its guidance on risk assessments for GP practices. The first section looks specifically at what impacts the adjustments required for high risk staff could have on practices, staff and patients. The mitigation that practices would need to consider could lead to a reduction in workforce and in activities that could affect patient safety, or an increased use of locum support and procurement of PPE, at a significant cost.  This section also covers a number of suggestions of what commissioners can do to support negatively impacted practices and it will form the basis of our discussions with the CCGs 

The second section sets out the risk assessment tools that are available to practices to use. 


PPE – face masks and coverings

As of this week, face masks and coverings should be worn by all hospital staff and visitors and GPC have requested this be extended to all healthcare settings, including primary care, so that everything is done to prevent the spread of infection and also reduce the risk of a whole team within a practice being required to self-isolate should one member contract COVID-19. 

 Practices should be aware of current guidance, which includes: 

The PHE guidance recommends that those working in reception and communal areas unable to social distance, should wear a fluid repellent mask.  GPC believes patients should be encouraged to wear face coverings whenever they attend the practice (with practices continuing to triage arrangements to keep face-to-face contact to a minimum) and that staff should continue to be enabled to work remotely whenever possible, to create more space for social distancing.  GPC also believes that CCGs and NHSE/I should fund perspex screens wherever needed to protect staff and reception areas and the LMC will raise this with the CCGs.  

Following the release of government guidance regarding the wearing of face masks in various public settings (including the circumstances where an individual might be exempt), practices are reporting increases in requests from patients for letters of exemption. The government guidance on exemptions suggests there is no requirement for evidence for exemption, therefore it should be sufficient for an individual to self-declare this. Practices are not required to provide letters of support for those who fall under the list of exemptions. The responsibility for issuing exemptions is with the transport provider, not GPs – see for example, this information from First Bus and Arriva. Similarly, practices are under no obligation to provide letters of support for anyone who does not fall under the list of exemptions but considers them to have another reason to be exempted.

See https://www.gov.uk/guidance/coronavirus-covid-19-safer-travel-guidance-for-passengers#exemptions-face-coverings 


Update from ICO regarding the protection of data during the COVID-19 Pandemic

Below is a useful recap on the processes health organisations should be following to ensure they are compliant with their data protection obligations and references a number of important guidance documents.


As lockdown eases and people return to work the ICO have also published some guidance for:

1) Employers and organisations that are planning on asking people if they have experienced COVID-19 symptoms or are planning to introduce staff testing:


2) Employers and organisations that are planning on using CCTV, thermal cameras or other surveillance methods as part of testing or ongoing monitoring of staff:



Covid-19 Antibody Testing for Staff

Failure of the government and NHSE/I to make available an occupational health service to general practice staff has brough about a variation in approach across the country to the provision of antibody testing for staff.   It is considered inappropriate to use the temporary resident mechanism to test staff and may be in breach of the GMS regulations.  Antibody testing for those working in general practice is not mandatory.  If those working in general practice wish to have an antibody test, we believe the results should be provided directly to the individual having the test and should not require the involvement of the employer.  The preferred route for staff to access the test is via the CCG commissioned service or through their own registered GP practice.

Indemnity provision under the CNSGP had been in question and the LMC wrote out to practices last week to highlight this issue.  However, confirmation has now been received that a separate national indemnity scheme specifically around coronavirus (the Clinical Negligence Scheme for Coronavirus) has been put in place and it has been confirmed it will cover this activity.    

See relevant link below:  


The FAQ is also a useful read  https://resolution.nhs.uk/faq-section/clinical-negligence-scheme-for-coronavirus/ 


Covid19 Pillar 2 lab results flow into GP records

NHS Digital have now implemented a process to facilitate the flow of Pillar 2 test results from COVID-19 tests undertaken through national testing to GP systems. These will appear in a patient’s record as a laboratory test result. The tests will have the requesting GP as G9999981 and GP Surname of COVIDpillar2; this will ensure they are clearly distinguishable from other test results.

  • These results do NOT need to be notified to PHE under the notifiable diseases requirement, this has already been done. This will also be clearly stated in the test result.
  • NHS England advise that there is no clinical action required on receipt of these results. 


CPR guidance for primary and community care

The Resuscitation Council, together with the Royal College of GPs, have published guidance for healthcare workers (HCWs) who are performing cardiopulmonary resuscitation (CPR) in primary and community care setting. The guidance clarifies that as CPR is an aerosol generating procedure (AGP) in the context of COVID-19, AGP PPE is the safest option for HCWs when undertaking chest compressions and other resuscitation procedures on patients with suspected or confirmed COVID. 

However, it is recognised that this may not always be achievable in a primary or community care setting depending on the availability of PPE. In the absence of AGP PPE, non AGP PPE if available for clinical care, must be worn as a minimum for resuscitation events. Read the guidance here.



Positive Covid-19 Tests and Life Insurance/Mortgages implications

The BMA has published guidance for doctors on life insurance and income protection during the pandemic, following a number of doctors having raised concerns about the impact of COVID-19 on their application and how insurers are taking into account the results of antibody and antigen tests for the virus, and after some reports about doctors having their applications for insurance policies deferred as a result of COVID. Read the guidance here


Hand Sanitiser Safety Alerts

The LMC wishes to bring to everyone’s attention the following regarding alcohol-based hand sanitiser:

Alcohol Hand Sanitiser – Vehicle Fires 

Highways England Safety Alert Alcohol Hand Sanitizer 


CQC – Emergency Support Framework (ESF)

Please find below a helpful guide to responding to CQC on the questions posed in the new ESF framework (credit to Cambridgeshire LMC).  Practices can expect to receive a phone call from Melanie Whittall or Anna Gleadell anytime now… 

Cambs LMC CQC ESF Guide 


Pensions guidance and update (England and Wales)

The BMA has updated its guidance for GPs about the annual allowance, following extensive lobbying, resulting in two important changes that affect the 19/20 and subsequent tax years. 

As an emergency measure for 19/20, NHS England made a commitment to pay the annual allowance tax charges in full for eligible clinicians in the England. Doctors who were subject to an annual allowance tax charge should use the option of the ‘scheme pays’ regulations to pay the tax due for 2019/20. From 2020/21 onwards the reduced Tapered Annual Allowance will only affect those with adjusted income of £240,000 and over. Read the full guidance here.

The BMA has also won a court appeal against the Government’s controversial changes to pensions rules introduced in April 2019, granting the Secretary of State for Health and Social Care the power to suspend pension payments to a doctors or NHS professionals charged with certain criminal offences, but not yet convicted. Read the BMA statement here


PCN DES (England)

NHS England has announced that 98 per cent of practices have chosen to participate in the Primary Care Networks (PCN) for 2020/21. The focus for PCNs and practices remain in dealing with COVID-19, but will also now be in expanding the workforce to relieve the workforce pressures for GPs, as the latest workforce data clearly showed. The DES remains modified including the investment and impact fund (IIF) having been replaced by the PCN support fund until at least October, with funding protected. It is for the PCN to decide how this funding is used. Read more about the PCN DES in the  GP practice toolkit.


LMC Law – Merger Advice and updated schedules for PCN network agreements

LMC Law Updated PCN Schedules v1.7 

Guide to Mergers and Takeovers in General Practice  


Named clinical lead for care homes – suggested wording for partnership agreements

LMC Law have provided the following wording for a partnership agreement where the practice has nominated an individual GP as the ‘Named Clinical Lead’ for a care home:

[X] shall be the nominated named lead for the [X] care home and shall have the responsibility to ensure that primary care services are delivered to the registered patients of the practice who reside within the care home. For the avoidance of doubt, the Named Lead shall consult with the remaining partners in respect of any delivery of services to that home and shall act in accordance with those decisions. The Named Lead shall not be liable for any implementation of any decisions properly made by the Partnership in respect of this clause.


Appraisal update

As recently reported the GMC has moved forward revalidation dates for those due to revalidate between 1 October 2020 and 16 March 2021, for one year.  NHSE/I have also confirmed that whilst appraisals remain on hold, the future of appraisals is still being discussed whilst they await the national decision confirming the date for recommencement of appraisals. 


Homeworking Policy

LMC Law have provided a Homeworking Policy which practices may find useful to check against policies they already have or as a template for use in the practice.    

 LMC Law Homeworking Policy June 2020 


QOF payments for 2019-20

NHSEI have committed to protect QOF income by making a one-off adjustment for practices who earned less in 2019/20 than 2018/19 as a result of Covid-19 activities.

NHSEI has run the calculations for 2019/20 using that year’s funding figures, patient numbers, prevalence etc. 

  • where the calculation results in a payment higher than was paid in 2018/19 (irrespective of whether they ‘achieved’ higher or lower), practices will receive that increased payment; 
  • where the calculation results in a payment lesser than was paid in 2018/19 they will bring that up to the same level as the 2018/19 payment (with the caveat that a minority will require a review).


Email submission of Crem 4 to West Suffolk Crematorium

Dr Ian Chapman the West Crematorium Medical Referee has confirmed that the preferred e mail address for cremation forms is  info@westsuffolkcrematorium.co.uk, sent from a NHS or local government e-mail address. 

Of relevance are the regulations that state…

“Where a hand-written signature has not been applied to the space in the form reserved for the signature the name of the signer should be typed in where the form allows. Examples of what may constitute an electronic signature include:

• Transmission from an email account belonging to the signer 

• A scanned copy of the signer’s signature applied to the signature section of the form 

• The signature of the signer applied directly to the form through a touchscreen

 • Use of an electronic signature verification service”

The practical implication of this is I can accept a typed signature if it comes from the email of an individual doctor. West Suffolk crematoriums internal guidance is that it will only accept NHS and local government email addresses for the purpose of receiving forms electronically.

If the forms are emailed to individual funeral directors and forwarded on to the crematorium we would accept them so long as there is a clear forwarding trail from a suitable email address (ie NHS or local government email address).

In summary , preferred method is form sent from NHS or local government account straight to info@westsuffolkcrematorium.co.uk , however if it is sent from an individual NHS or local government email address to a funeral director, they can forward it on to us.


Annual Flu Campaign 2020/21

NHSEI has published the annual flu letter for the 2020/21 programme. It is recognised that delivering the flu immunisation programme is likely to be more challenging this year because of the impact of COVID-19.  NHSEI will publish further guidance nearer the planned start of the programme in September 2020, but in the meantime, practices should continue to plan for the programme as usual. The letter sets out which groups are eligible for flu vaccination (same as last year but different vaccinations for different groups) and how to prepare for this autumn’s vaccination campaign.


Local Authority Enhanced Services

The LMC is meeting with the Local Authority on Thursday 25th June when it is expected that they will put forward their plan for recommencing the enhanced services from July onwards.


LMC Vacancy – Medical Director

Please see links below for job advert and information pack for the above vacancy.

Suffolk LMC Medical Director Job Advert  

Suffolk LMC Medical Director Information Pack  

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