October 2020 Newsletter
Sunday 1st November 2020 in Suffolk LMC Newsletter
Included in this Edition:
- Key matters reviewed by the committee in October
- Welcome back to work
- Covid – General Practice during a Second Wave
- NHS Covid App – FAQs
- New advice for patients at high risk of COVID-19 infection
- Covid-19 -Processing of patient confidential information in line with COPI – extension granted to 31st March 2021
- Remote fit notes – please remember to sign them
- Influenza immunisation FAQs (England)
- Ordering additional adult flu vaccine stock
- Staff Flu Vaccinations
- Practice Support from RCGP
- Roche
- Clinical validation of surgical waiting lists framework and supporting tools
- Complaints (KO41b form) data collection for 2019/20
- CVDPrevent
- Business Continuity Plans
- BMA Pensions newsletter
- DDRB pay award and template letter
- New to Partnership Payment Scheme
- Changes to the Supporting Mentors Scheme
- CQRS system supplier change
- Practice Vacancies
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Information, Guidance and News
Key Matters reviewed by the Committee October 2020
Key topics of discussion have been:
- Social Services Referral process
- Dermatology referrals/Teledermatology
- Addenbrookes Dermatology Referrals – mandated photos
- Covid – Income protection for practices
- Think 111 First
- Premises Developments
- PMS Development Framework
- QOF protection
- DVT LES (West
- WSH Building Project
- Flu Summit
- Transfers of workload from hospitals
- Liaison with ESNEFT Clinical Director
- Liaison with WSHFT Clinical Director
- Liaison with WS CCG
- Liaison with I&ES CCG
Welcome Back to Work
For more details about this scheme for GPs in Suffolk please see information here
Covid – General Practice during a Second Wave
The BMA has proposed a series of measures outlined in COVID-19: General practice during a second wave to support practices so that they are able to deliver care to patients and protect their staff during a second wave this autumn and winter.
NHS Covid App – FAQs
https://faq.covid19.nhs.uk/article/KA-01121/en-us?parentid=CAT-01031&rootid=CAT-01023
New advice for patients at high risk of COVID-19 infection
Following the announcement of a new three-tier lockdown approach in England, the DHSC have published updated guidance for those considered most clinically vulnerable, depending on the level of risk in their local area, in line with the new Local COVID Alert Levels framework.
This new guidance provides advice for the clinically vulnerable to follow in addition to the new rules and guidance for everyone based on the level of risk in their local area. The government are not yet suggesting the reintroduction of shielding arrangements that were paused in the summer. More restrictive ‘shielding’ measures could be considered in the future in areas facing the highest risk and if that happens the Government will write to relevant people separately to inform them directly should they be advised to shield.
Whatever the current local COVID alert levels are GPC have made it clear, GP practices remain open and whilst remote consultations should be the main way in which patient care is delivered, when it is clinically necessary to see vulnerable patients face to face we would normally expect them to attend the surgery with good infection control arrangements in place.
Read more in the updated guidance for patient at high risk
Covid-19 -Processing of patient confidential information in line with COPI – extension granted to 31st March 2021
LMC Law has asked us to remind practices to update their privacy notices in the light of the extension of the regulations requiring organisations such as GP Practices to share confidential information with other organisations to enable them to respond to and deal with the COVID-19 pandemic. This was originally due to expire on 30th September 2020, but a further notice has extended the deadline to 31st March 2021. The notice also adds ’processing to support NHS Test and Trace’ as a Covid-19 purpose. Practices will need to inform patients that there has been an update to their Privacy Notice and amend the review date of their Privacy Notice accordingly. LMC Law have provided the following suggested wording here
Remote fit notes – please remember to sign them
DWP will accept fit notes that are printed, signed, scanned and e-mailed to patients. This advice has also been given to employers, who should also be accepting signed, scanned and emailed fit notes.
However, DWP is receiving a significant number of unsigned fit notes which they cannot accept and this results in inconvenience for both patients and GPs. We would therefore remind GPs that fit notes must be signed. Read more about remote fit notes in our COVID-19 toolkit for practices
Influenza immunisation FAQs (England)
NHSE/I have produced a set of FAQs relating to the influenza immunisation programme and can be found here. They have also issued guidance here on how practices and CCGs can use the additional £15.4m made available to local systems and primary care providers to cover reasonable additional costs (over and above the usual fee structures) associated with this year’s extended flu programme.
Ordering additional adult flu vaccine stock
DHSC has written to practices to confirm the process by which they will be able to access the additional adult flu vaccine stock secured to support the expanded vaccination programme this season.
Staff Flu Vaccinations
Just a reminder that the correct course of action if practices wish to vaccinate their own staff is to register as private patients rather than TRs or immediately necessary. CNSGP does not cover clinical negligence for providing occupational health services so you will need to check that you are covered with your MDO – although we understand that all the MDO’s have agreed to cover again this year. See flow chart attached.
Practice Support from RCGP
The RCGP have via LMCs issued a reminder that they are able to offer practices a range of support services – this can be support for practices with adverse CQC ratings, CQC Inspection preparation, strengthening leadership, enhancing practice communication, PCN support, workforce analysis and embedding new roles.
The website gives more information https://www.rcgp.org.uk/primary-care-development.aspx
The point of contact is Victoria Gaffney – contact details Tel: 07818 372764 or Victoria.Gaffney@rcgp.org.uk
Roche
We understand from the CCGs that although supplies from Roche have not yet returned to normal the advice is that practices from 26th October 2020 can recommence requesting non urgent biochemistry tests but are asked to hold off dealing with the backlog which has occurred during the restrictions until the hospitals have sufficient supplies to cope.
Following discussion with the CCGs about the difficulties for practices who are not only in a catch up situation with monitoring of long term conditions but now further impacted by the Roche debacle the I&ES CCG have agreed that they would be happy to provide a ‘letter of comfort’ outlining the unavoidable delays in routine monitoring for any practices due to undergo a CQC inspection. We are expecting that the WS CCG will agree to provide this as well and we are awaiting confirmation.
The LMC has also discussed with the CCG the workload and financial impacts on practices. The CCGs are currently looking at a system for reimbursement but the mechanism/amount of reimbursement is yet to be confirmed but in the meantime it would be very useful to draw on some examples of practice expenses, particularly from practices in the East.
GP Hub (West) – We understand that updates on the pathology situation can now be found in the diagnostics/pathology section of the GP Hub (West Suffolk Hospital) via https://www.wsh.nhs.uk/GPInfo/GP-information-hub.aspx
Clinical validation of surgical waiting lists framework and supporting tools
NHSE/I has published the clinical validation of surgical waiting lists framework and supporting tools, designed to support systems to clinically validate their waiting lists and establish patient’s wishes regarding treatment. This project is centred around making the best mutually agreed decisions with patients regarding their treatment and is not an exercise to reduce numbers on waiting lists.
The hospital will contact all patients on an admitted pathway by 23 October 2020 to establish their wishes about their preferred next steps. The patient’s GP practice will then be notified of the outcomes of discussions regarding their procedure.
Complaints (KO41b form) data collection for 2019/20
Following lobbying for a reduction in bureaucracy impacting practices, and particularly in light of the current pressures that general practice face in responding to COVID-19, NHS Digital have confirmed that the annual complaints (KO41b form) data collection relating to 2019/20 will not be collected as usual. Practices are instead encouraged to continue to use the information collected locally for local service improvement purposes. Read more here
CVDPrevent
We understand that the original communication about CVDPrevent was sent to the registered CQC manager rather than via the usual NHSE gateway distribution list. Practices have been asked to confirm acceptance on CQRS. The extract is anonymised data and is directed (mandated) under the H&SC Act. Emma Cooper of Kafico has confirmed that patient consent is not required and all practices are required by law to participate
More information can be found https://digital.nhs.uk/about-nhs-digital/corporate-information-and-documents/directions-and-data-provision-notices/data-provision-notices-dpns/cardiovascular-disease-prevention-audit
Practices are also reminded that privacy notices need to be updated in the light of the CVDPrevent extraction and patients have a right to be informed which is usually done via your Covidwebsite.
Business Continuity Plans
With heightened concern about COVID infection rates once more, both CCGs are keen to support practices and the wider healthcare economy by ensuring business continuity plans are up to date and robust. The LMC strongly support this approach, with its inherent emphasis on staff safety, and we are seeking examples of good/innovative practice which could be shared.
See link here for the template document previously provided by NHSEI which may be useful as a checklist for what to include in the plan.
BMA Pensions newsletter
The BMA’s pension committee has been at the forefront of negotiating to maximise pension benefits. See the first quarterly newsletter here. The newsletter provides an update on what actions the committee is taking on a range of issues.
DDRB pay award and template letter
The Sessional GPs Committee has received reports that some salaried GPs are struggling to get the 2.8% pay uplift recommended by DDRB and approved by the government. Practices are encouraged to apply the uplift across all of their employed GPs. It is a contractual requirement to implement this pay increase for salaried GPs employed on the model contract. Read more in the Sessional GPs newsletter.
New to Partnership Payment Scheme
Practices are now making applications so that new partners can benefit from the ‘new to partnership payment’ and we would encourage all practices with partners who have joined the practice since 1 April to do so. However, a potential issue has been identified with the ‘New to Partnership Payment Scheme’ which applies to new clinical partners from 1 April 2020, causing a ‘catch 22’ situation.
It is known that new partners often commence with fixed share ‘probationary’ period, before moving to a full equity share. GPC have discussed this issue with NHSE/I and it has been agreed that in these situations, an individual will be accepted on to the scheme once they become a shareholding partner on an equity basis, as long as the probationary period commenced after 1 April 2020.
NHSE/I has also considered the barriers to individuals obtaining the evidence required to support their application to the New to partnership Payment Scheme, and have identified alternative evidence that can be submitted:
- Where a Partnership Agreement is not available, a headed letter from the practice to confirm details will be accepted.
- To evidence the practice contract type NHSE/I will now check the CQC website to obtain this information for GMS and PMS contracts. They will still require a copy of any APMS contracts.
These changes are effective immediately and the guidance documents have been updated. Those who have already applied to the scheme will be contacted by NHSE/I and do not need to reapply.
Changes to the Supporting Mentors Scheme
NHSE/I has amended its guidance in relation to the recognised accredited mentorship qualification that mentors should receive via the supporting mentors scheme. In the original national guidance, the ILM Level 5 in Coaching and Mentoring was cited as a benchmark example, however it is now recognised that there are a number of other mentorship qualifications that are equally high quality and will equip mentors with the right mentoring skills and knowledge. The guidance has therefore been updated so that systems have the flexibility to deliver other appropriate mentorship qualifications that are equivalent to ILM Level 5, with the agreement of NHSE/I regions.
CQRS system supplier change
NHSE/I is overseeing a programme to bring the running and development of the CQRS system in-house from 1 November 2020 and to introduce a new centrally funded system (CQRS Local) to support locally commissioned schemes by April 2021. These changes aim to streamline processes and reduce the administrative errors in GP payments.
A structured transition is in place to ensure the continued provision of the CQRS system from November with minimal interruption for end users. How users access and use the CQRS system is not changing and no action is required from practices or commissioners. From 1 November the new number for the CQRS service desk will be 0330 124 4039, although the email address remains support@cqrs.co.uk. See new CQRS welcome page
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