June 2023 Newsletter

Included in this newsletter:

  • Flu 2023/24
  • Serious Data Leak
  • Travel Vaccinations
  • RCGP Veteran Friendly Practices
  • Learning Disability & Autism Training
  • Accelerated Access to Records

 

Information, Guidance and News

Flu 2023/24

The 23/24 Annual Flu letter confirms the cohorts for this season, which does not include the healthy 50-64 yr.  Whilst the JCVI have referenced this cohort, you will notice in the table that the 50-64 yrs are flagged as enhanced as opposed to routine.

The below groups will be eligible for a flu vaccine from 1 September 2023:

  • those aged 65 years and over
  • those aged 6 months to under 65 years in clinical risk groups (as defined by the Green Book, chapter 19 (Influenza))
  • pregnant women
  • all children aged 2 or 3 years on 31 August 2023
  • primary school aged children (from Reception to Year 6)
  • those in long-stay residential care homes
  • carers in receipt of carer’s allowance, or those who are the main carer of an elderly or disabled person.
  • close contacts of immunocompromised individuals
  • frontline workers in a social care setting without an employer led occupational health scheme including those working for a registered residential care or nursing home, registered domiciliary care providers, voluntary managed hospice providers and those that are employed by those who receive direct payments (personal budgets) or Personal Health budgets, such as Personal Assistants

The JCVI have issued recommendations for influenza vaccines for 2023/24.

† LAIV the vaccine of choice for the children’s programme 2-17 year olds
‡ Advised as a temporary cohort during the COVID -19 pandemic influenza 2020/21, 2021/22 and 2022/23 seasons. Policy for 2023/24 to be confirmed.

Serious Data Leak

We are asking for your help in drawing this breach to the attention of all sessional and locum GPs Please share this with anyone you feel should be aware.   Lantum Health (formerly known as Network Locum) have accidentally disclosed 98,000 files pertaining to doctors registered with their business, in an unencrypted form on a cloud computing platform called Amazon Web Services Storage (S3).

The files have now been removed from public view, but it is unclear how long they were public for or whether copies have been downloaded.  The exposed files, dating from 2014 – 2016, include sensitive information about healthcare professionals, including full names, dates of birth, current and past employers, home addresses, phone numbers, email addresses, passport information, medical documents, certifications, criminal record, invoices/Payroll.

As you can see this data goes far beyond the usual email address and password type disclosure and contains information which could easily be used to steal someone’s identity.  As yet there is no way for any individual GP to know whether they are in the breach. Any GP who has ever registered with Network Locum or Lantum should assume they are affected. It is not clear at this stage what action, if any, can be taken to mitigate the risk of identity theft or other deleterious effects now that the data is potentially out there. It is possible that the affected individuals could have recourse to legal remedy. We will update as more is known.

Travel Vaccinations

A reminder that the following vaccinations must be given as part of NHS provision and no fee can be charged to a registered patient: Cholera, Hepatitis A, Poliomyelitis, Typhoid

The requirement on practices is to “have in place a system for delivering appointments at which relevant vaccines or immunisations are administered to patients (“immunisation appointments”)”.  Not limitless appointments.

Vaccinations that are not free of charge on the NHS and can therefore be declined or signposted elsewhere are: Hepatitis B, Meningitis vaccines, Rabies, Tuberculosis (TB), Japanese encephalitis and tick-borne encephalitis, Yellow fever (only available in designated centres)

BMA Guidance can be found here

 

RCGP Veteran Friendly GP Practices

Armed Forces Week is on the 24th June https://www.armedforcesday.org.uk/  Suffolk has one of the highest populations of veterans in the East of England but comparatively few practices are accredited as Veteran Friendly (VF) across our region. This programme enables practices to deliver the best possible care and treatment for patients who have served in the armed forces.

Nearly 1,000 GP practices in England are already accredited through this programme which supports practices to identify and code their veterans, and to appoint a clinical lead who undertakes training and other activities related to veteran healthcare.

Accreditation is voluntary and currently open to GP practices in England. For more information, telephone Stephen Heard (the regional lead East of England) of the RCGP Veteran Friendly Accreditation Project (contact: 01493 717257) and he would be delighted to extol the virtues and benefits of becoming a Veteran Friendly practice. Alternatively, please email veterans@rcgp.org.uk

BMA GPC Update

BMA secures significant reduction in NHSPS service charge claims for practices

The BMA has successfully assisted 5 GP practices in significantly reducing years of unsubstantiated service charge claims demanded by NHS Property Services (NHSPS) – with one practice seeing NHSPS’ claim against them reduced by more than £400,000, a reduction of more than 80%. The landmark cases, brought in 2020, were started after practices began to struggle to afford soaring service charges set by NHSPS, despite there being no prior agreement or explanation for the price hike.

 

BMA lawyers challenged NHSPS on two issues: the legal basis on which the charges were being imposed, and the magnitude of the fees. During the first phase of the case, the BMA and the practices sought a legal declaration that NHSPS could not rely on its Consolidated Charging Policy as a basis for issuing the new charges, and that the imposition of the higher charges was therefore, unlawful. Despite the outbreak of the Covid-19 pandemic and the extraordinary pressure this placed GPs under, NHSPS launched a countersuit against each of the practices demanding recovery of the historical service charges, transforming the dispute into a major commercial lawsuit.   

 

In June 2020, NHSPS admitted that its charging policy had not been incorporated into or retrospectively varied the practices’ legal terms of occupation and existing service charge obligations. The BMA then assisted the five practices in settling with NHSPS the fees and service charges sums outside of court, for the period between 2013/14 and 2019/20, securing reductions on the amounts claimed by NHSPS for the five practices ranging from £25,000 to more than £400,000, a total reduction of more than £750,000.

 

The BMA has created guidance for practices in a similar position, to help advise them on what to do if they are also facing disproportionate service charges.

 

Junior doctors’ and GP trainees strike action

The BMA has announced further industrial action to be undertaken by junior doctors (including GP Trainees) in England, after Government failed to make credible pay offer. A 72-hour walkout will take place between 0700 on Wednesday 14 June and 0700 on Saturday 17 June. GPC England supports all junior doctors, including GP trainees, in their pursuit for pay restoration to 2008 levels, and we would urge practices in standing with GP trainees in their fight for fair pay. Show your support for the future of healthcare in England.

 

We have published comprehensive guidance for GP practices, trainers and LMCs which covers everything from managing the impact of strike action on practice work to GP trainee rotas and information on how GP practices can support GP trainees financially. We have produced a poster which we encourage you to display in your practice, a patient information leaflet, and an infographic that can be used on your website – order here. The BMA has also published guidance on strike action for GP trainees.

 

BMA member briefing on the GP delivery plan

ICBs are responsible for ensuring that providers are fulfilling the requirements in the plan and to monitor and report to NHSE the progress being made.  We have now published template letters to support practices and LMCs to engage with their local Integrated Care Boards (ICBs) regarding the implementation of the primary secondary care interface elements of the plan.

 

NHS.net email for locums

We have had confirmation that the licences for Microsoft Apps for Enterprise for those in the locum container of NHSmail will continue to be provisioned for the next financial year following work by NHS England.  These licences are required to use desktop versions of Office 365 (e.g. Microsoft Word) which can link into clinical systems for the creation of referral forms. The Sessional GPs Committee repeatedly raised the necessity of such access when issues first came to light in January 2021 after parts of the country moved to Office 365 and continues to make the case for ongoing access on your behalf. For more tips on the use of the locum container, see the blog by Mark Coley, GPC England IT lead, here

 

Parliamentary activity

We have written to the Primary Care Minister, Neil O’Brien to highlight the motions passed at LMC UK conference regarding increased costs of running practices, and pay restoration for practice funding, and the Minister has agreed to meet to discuss these issues. We have also written, with the chair of Northern Ireland GPC, to the Chancellor, Jeremy Hunt, asking for him to work with DHSC to deliver a package of support to meet increased practice costs, particularly those linked to inflation. In addition, GPCE and the sessional GPs committee have written to Sir Keir Starmer to outline our key concerns and priorities for the future of general practice following their recent NHS plan and offered a roundtable with him and his team to discuss Labour party policy in this area. We have also met with a special advisor to the Shadow Health secretary to discuss the future of general practice. Following our meeting we were encouraged to see Labour MP Karin Smyth, raise our concerns regarding spiralling costs to practices during health questions in the House of Commons.

 

Oliver McGowan Mandatory Training on Learning Disability and Autism.

All GP practices in England must ensure their staff receive training in learning disability and autism, including how to interact appropriately with people with a learning disability and autistic people. This requirement was introduced by the Health and Care Act 2022 in July last year.

 

The government’s preferred training programme is the Oliver McGowan Mandatory Training on Learning Disability and Autism. However, the Act does not specify a training package or course for staff. The CQC cannot tell practices specifically how to meet their legal requirements in relation to training, and while NHS England and ICBs may share the government’s training programme preference and encourage uptake, it is ultimately for practices to determine how their staff are trained to meet their legal requirements. Further information is available here.

 

Accelerated Access to Records

Following the imposition of the GP contract, practices will be expected to provide automatic prospective record access to all patients from 31st October 2023. While GPC England remains committed to finding a way forward whilst acknowledging the reality on the ground for GPs, we have prepared guidance outlining steps practices should take ahead of the planned switch on. If you have any questions not addressed in the guidance, please get in touch with info.gpc@bma.org.uk

 

EMIS reverses panic button decision.

BMA lobbying has helped GP practices to retain the EMIS panic button, which is used in emergency situations, as EMIS has decided that the EMIS panic button will continue to be available for practices who wish to keep it. The number one priority for any doctor is ensuring patient safety, which is why changes to the EMIS system have an impact. We have a duty of care to voice our concerns when there is a risk and are pleased to see they have been taken seriously. Although we know that some practices face technical challenges with the system so do not use it, this is a sign that the NHS IT infrastructure is seriously inadequate. We need to see actual investment in practices to not only help them stay open but ensure that they are as safe a space as possible.

 

OpenSAFELY.

 In recent months GPCE’s Digital Transformation Policy Group, along with the Joint GP IT Committee, have been providing scrutiny to the forthcoming Data Provision Notice (to be sent under the COVID-19 Directions from the Secretary of State for Health and Social Care) that will allow OpenSAFELY to continue to operate as a Trusted Research Environment (TRE) once its COPI permission expires on 1 July 2023. It has been a complex process with regard to information governance. The proposal speech to Motion 12 at the conference of England LMC representatives last November referenced the OpenSAFELY TRE as one that has the support of the profession. This remains the case. Practices will not need to do anything and formal communication from NHS England explaining the evolving legal basis for operation will be coming soon.

 

Practice Vacancies

Can be found on the LMC Website http://www.suffolklmc.co.uk/jobs



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